Oral Answers to Questions

SCOTLAND

The Secretary of State was asked—

Alcohol Sales

James Duddridge: What discussions he has had with ministerial colleagues about the sale of alcohol on public transport between Scotland and England.

Alistair Darling: There are no proposals to amend the provisions with regard to the sale of alcohol on public transport between Scotland and England.

James Duddridge: I thank the Secretary of State for that clarification, but he will forgive me for not having been really sure. One thing seems to be happening in Scotland and the Home Secretary seems to be doing another in England. I can forgive the Secretary of State for Transport for not communicating with the Home Secretary, but can he explain why the Secretary of State for Scotland has problems communicating with the Secretary of State for Transport on rail matters, given that it is himself? Can he clarify those matters?

Alistair Darling: I understand the disappointment when a Member asks a question and receives an answer that he was not expecting. All I can say to the hon. Gentleman and the House is that there are no proposals to change the law.

Jim Sheridan: Does my right hon. Friend have any concerns about the sale or consumption of alcohol on public transport between Scotland and England? As far as I am concerned, there is nothing wrong with having a sensible drink and perhaps a meal while travelling on the train from Scotland to England.

Alistair Darling: I agree. Many people enjoy a drink on train services between Scotland and England, as they do on aeroplanes. As I said, the Government have absolutely no plans to change the law in that regard, nor have they any plans to change the law with regard to the consumption of alcohol on trains generally in England—in other words, on the non cross-border services. There are no plans to change the law at all.

Eleanor Laing: That was an interesting answer. Did the Secretary of State hear the Home Secretary speaking today at great length about promoting responsible drinking? Does he intend to promote responsible drinking in Scotland, too?

Alistair Darling: All of us would sign up to the proposition that people should act responsibly at all times whether they are on public transport, in a pub, on the street or wherever. That makes sense north or south of the border.

Devolution

Anne McIntosh: What devolution issues the Advocate-General has considered since 18 October.

David Cairns: The Advocate-General has had a further 74 devolution issues intimated to her since 18 October.

Anne McIntosh: Is the Minister aware of the serious situation arising from the fact that the permanent regulations on Scottish legal aid have not yet been passed by the Scottish Legal Aid Board and the Scottish Executive, meaning that many counsel have to withdraw from representing clients, especially in appeal cases? Not only are their expenses not being met, but it is costing them money to represent clients in those circumstances. Will the Minister make urgent representations to the Advocate-General, the Lord Advocate and the Executive to ensure that those regulations, which were due to be adopted in September, will be passed at the earliest opportunity?

David Cairns: The hon. Lady asked a question in connection with legal aid at the last Scotland questions and I shall give her the same answer as she received then: issues to do with legal aid are devolved to the Scottish Executive and it is entirely a matter for them.

Alex Salmond: What advice was sought or given by the Advocate-General on the Government's terrorism legislation? We know that the Home Secretary, in an arrogant and dismissive attitude to Scots law, did not seek the advice of the Lord Advocate and we know that, in a craven way, neither the Lord Advocate nor the First Minister offered advice. The Advocate-General has a role in those matters, so will the Minister tell us whether she was treated in the same dismissive and contemptuous way?

David Cairns: The Advocate-General is a UK Law Officer and as such takes part in a wide range of discussions on all aspects of UK law. Terrorism legislation is entirely a reserved matter. Discussions took place between officials at the Home Office and the Crown Office on how the issues would be implemented, but they are reserved matters and it was for the House to decide.

Alistair Carmichael: Surely the Advocate-General should at least have suggested to the Home Secretary that he speak to the Lord Advocate about those matters. Is not the embarrassment now shared by the Home Secretary and the Lord Advocate, because of the failure to consult, the responsibility of the Advocate-General?

David Cairns: No, this is clearly a reserved matter and as such the Advocate-General can give advice, as she does on a range of issues as part of being a UK Law Officer. The policy issues were a matter for the House, and the House has decided that policy.

Smoking

David Mundell: What assessment he has made of the possible economic impact of the proposed smoking ban in Scotland.

David Taylor: What assessment he has made of the likely impact of legislation to ban smoking in enclosed public places and workplaces in Scotland from 2006.

Alistair Darling: In Scotland, health issues are the responsibility of the Scottish Executive. As the House will know, smoking is the greatest single, preventable cause of ill-health and premature death in Scotland.

David Mundell: I note the Secretary of State's response, but can he tell me what evidence there is that smoking is less dangerous in England than in Scotland? If there is no such evidence, why should my constituents who operate pubs and clubs across Dumfriesshire bear the commercial downside of this differential smoking policy, when smokers can simply go a few miles down the road to Carlisle for a night out?

Alistair Darling: The hon. Gentleman is right to suggest that smoking damages people's health no matter where they smoke. However, health is devolved to the Scottish Parliament, so it is entirely up to it to take a different view from the legislation that applies to England. The experience internationally—for example, in New York and Dublin—is that the ban has not been damaging in the way that its opponents feared. Indeed, many people enjoy the opportunity to go out to a place where they will not breathe in other people's smoke.

David Taylor: I am delighted that, from 26 March 2006, protection will be given against the carcinogenic effects of second-hand smoke to bar workers across Scotland, not least in the constituency of Airdrie and Shotts. Does the Secretary of State agree that next year's comprehensive smoking ban north of the border may result in health inequalities for the expatriate Scottish community in constituencies such as mine, where staff in non-food pubs and members clubs will have no such protection under the Health Bill? Will he discuss that with the Secretaries of State for Health and for Defence?

Alistair Darling: I have no doubt that my hon. Friend will have plenty of time to make his proposals when the legislation comes before the House. As I suggested to the hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) just a few moments ago, devolution inevitably means that legislation will differ, from time to time, north and south of the border. There is nothing wrong with that. Indeed, it was always anticipated that that would be the case. Of course, the extent of the ban in England was set out in the manifesto on which he and I both stood.

Jo Swinson: Given that there are 13,000 deaths each year as a result of smoking and many more thousands of people suffer illnesses as a result of the harmful effects of tobacco smoke, does the Secretary of State agree that the smoking ban in public places in Scotland will improve public health and that a healthier work force must therefore be good for the economy?

Alistair Darling: That is a very difficult question, but I think that the answer is yes.

Electricity

Philip Hollobone: What proportion of Scotland's electricity consumption was generated in Scotland by (a) nuclear, (b) hydro, (c) gas, (d) coal and (e) other sources in 2004–05.

Alistair Darling: In 2003, about a sixth of all Scottish generated power was exported to England and Northern Ireland. The energy sources for electricity generated in Scotland are given in "Energy Trends", which is published by the Department of Trade and Industry. The last edition appeared in December 2004.

Philip Hollobone: Has the Secretary of State seen the report in The Scotsman today, which quotes a leaked Government report that Britain is on track to miss its carbon emission targets? Given the size of the nuclear generation industry in Scotland, by when must a decision be made for new nuclear capacity in Scotland if it is to improve its carbon footprint?

Alistair Darling: On the targets, the hon. Gentleman and the House will be aware that the Government are reviewing our policies at the moment, because it is important that the targets that we set ourselves are met. Indeed, we have done many things over the past two or three years. For example, last week, I announced proposals on biofuels that would involve taking about 1 million tonnes of carbon from the atmosphere. That is equivalent to taking more than 1 million cars off the roads every year.
	On nuclear power, the Prime Minister has made it clear that part of our energy review will include whether we either extend the lives of the present nuclear generating plants or build new plants. The decisions on extending the lives of the existing nuclear plants must be taken in the next few years, first in relation to Hunterston and then Torness. Of course, as part of the review, we will decide whether new nuclear plants will be needed in the future.

Gordon Banks: Will my right hon. Friend take this opportunity to tell the House what measures the Government are taking to ensure that the full potential of wind power in Scotland is exploited to the benefit of energy consumption in Scotland and the UK?

Alistair Darling: I agree with my hon. Friend's suggestion that it is important to do everything that we can to extend the amount of power that is generated by wind and other renewable sources. It is unfortunate, however, that many people who call for an extension of renewable power set about opposing the very means to deliver it—both the generators themselves and the power lines needed to carry the electricity. I agree that it is very important for both Scotland and the UK that we generate as much renewable energy as possible.

John Thurso: Is the Secretary of State aware of the considerable socio-economic development potential afforded by wet renewables, especially in remoter parts of Scotland? There is a possibility of not only developing generating industries, but providing local, cheap, green electricity. What discussions has he had with the Minister for Energy about the application of section 185 of the Energy Act 2004, which was referred to in his Department's response to a recommendation in a report by the Scottish Affairs Committee? Will he ensure that any benefit that accrues from that will go not simply to the islands, but to remoter parts of the mainland?

Alistair Darling: The hon. Gentleman will know that my hon. Friend the Minister for Energy said on Friday that the Government intended to extend powers under section 185 so that an advantage could be given to the generation of electricity on the islands. It will be well worth examining that.
	I assume that the proposal would apply to Thurso. I understand that the hon. Gentleman owns a large amount of water in the north of Scotland, if not all of it—I declare an interest for him since he forgot to do that. I shall have a word with my hon. Friend the Minister for Energy to determine whether anything can be done. The hon. Gentleman is right that electricity can be generated on a small and local basis. Indeed, that is one of the things that my hon. Friend the Member for Edinburgh, North and Leith (Mark Lazarowicz) wants to encourage. My hon. Friend's Bill received its Second Reading on Friday, so I hope that that will encourage such activity.

David Hamilton: Is my right hon. Friend aware that an advanced development is taking place on carbon capture, through which carbon can be put back into coal seams in the earth? Will he discuss with his colleague in the Department of Trade and Industry the possibility of arranging funding to develop that process, as we are sitting on billions of tonnes of coal—Scotland produces 6 million or 7 million tonnes of coal a year?

Alistair Darling: I am aware of those developments for not only coal, but gas. The possibility of carbon recycling is being investigated, especially at Peterhead power station. The Government are considering that process; the argument is whether it should be classed as renewable energy and treated similarly to that. We can all agree that it is absolutely essential to do much more to reduce the amount of CO 2 that is produced. Every bit helps, so we will certainly want to have a look at such energy generation.

Eleanor Laing: With respect, the Secretary of State did not answer the supplementary question asked by my hon. Friend the Member for Kettering (Mr. Hollobone). If the Secretary of State agrees with the leaked Government report cited in today's edition of The Scotsman, which admits that Britain is set to miss its targets for reducing carbon dioxide emissions, why is he dithering and being so vague about alternative sources of energy, especially nuclear, wind farms and other renewable sources? He technically gave an answer to my hon. Friend's question, but it was so vague as to be meaningless. Is he going to do nothing at all to reduce carbon dioxide emissions?

Alistair Darling: First, on renewable energy, the hon. Lady would be on much firmer ground if it were not for the fact that her colleagues constantly call for the postponement of planning consent for renewable energy projects, such as wind farms, and constantly complain about erecting the power lines that would be needed to transport such energy. The Conservatives say that we should be doing more, but at every turn they oppose measures that would encourage the development of renewable energy.
	I said to the hon. Member for Kettering (Mr. Hollobone) that we need to consider nuclear power. For a long time successive Governments have shelved the problem. Given the pressing need to reduce CO 2 emissions,we need to examine that matter because that is a sensible way forward. As I have said, the CO 2 targets are tough and demanding, but the Government will do everything that they can to meet them. That stands in contrast to the Conservative party—I do not recall that it expressed any enthusiasm for the subject during the 18 years in which it was in office.

Eleanor Laing: We are not here to talk about my colleagues or the Conservative party. We are here to ask the Secretary of State what he is going to do, and he still has not answered the question. We have had an awful lot of fine words—"This is good and this is bad; this party or that party says this or that"—but the Secretary of State still has not told us. There are some serious matters. There is the need not just to reduce carbon dioxide emissions, on which we all agree, but to secure supplies of energy, particularly electricity, which we have been warned—my party has warned—is not necessarily secure should there be a particularly cold winter. What, I ask again, will the Secretary of State actually do about it, rather than just saying "We'll review this and we'll look at that" and talk about what happened 18 years ago? We are interested not in 18 years ago but in what he is going to do now for the future.

Alistair Darling: I can understand why the hon. Lady does not want to talk about the Conservative party. Let us take, for example, renewable electricity generation, and particularly wind farms. We are in favour of that and we support those developments; the hon. Lady's party is against them. It is all very well having an energy policy and an aspiration, but if she is not willing to give effect to it by ensuring that such things happen, it is not a policy at all.

Mark Lazarowicz: My right hon. Friend will be aware of the burgeoning wave power industry in Scotland and he will know that it was very pleased when, after quite some delay, the European Union approved the Department of Trade and Industry scheme to support marine technology such as wave power. However, the industry is concerned that decisions on allocating the funding that has been approved will not be made until January at the earliest. Will my right hon. Friend encourage speedy decision making by the DTI to support that important industry, which has so much potential for Scotland and the entire UK?

Alistair Darling: My hon. Friend is right that the European Commission has only just cleared that funding for state aid purposes. I am told that the DTI expects to ask for bids in the first quarter of next year. I do not know whether anything can be done to bring that forward, but I shall find out and write to my hon. Friend.

Class A Drugs

John Robertson: What discussions he has had with the First Minister and his ministerial colleagues on the measures required to reduce the availability of class A drugs in Scotland.

David Cairns: I and my right hon. Friend the Secretary of State have regular discussions with Scottish Executive Ministers on a wide range of issues.

John Robertson: I thank my hon. Friend for his reply. He will be aware of the by-election held in my constituency in Knightswood Park last week, where Labour received 55 per cent. of the vote. One of the main issues on the doorstep was the effect that drugs are having on the community—[Interruption.] That is obviously not important to Opposition Members. I draw my hon. Friend's attention to the recent article in the Sunday Mail about the Daniels family, who amassed more than £16 million through drug peddling. Will he continue to work closely with the Scottish Executive to find solutions to prevent the misery and havoc that the drug culture wreaks on our communities, and will he do something about these parasites?

David Cairns: Every hon. Member is aware of the scourge of drug consumption—it ruins the lives of addicts, the lives of their families and the lives of those who have to live among people who deal in drugs. The Scottish Drug Enforcement Agency has had some considerable success. In the first six months of 2004–05, it seized more class A drugs than during the whole of the preceding 12 months, and so far this year it has seized class A drugs with a potential street value of more than £22 million.
	My hon. Friend rightly highlights the work of the Assets Recovery Agency, which takes away the assets of those suspected of drug dealing. We cannot come down too hard on these people because they ruin lives and they ruin communities.

Michael Connarty: Does my hon. Friend agree that one way to deal with the availability of class A drugs is to deal with demand? Everywhere I have been—Colombia and Afghanistan—the argument has been that if we were not demanding drugs, they would not be supplying them. One problem appears to be that we still use a methadone substitute for those who are addicted, but buprenorphine has been used in other countries—and in an experiment in Bassetlaw—to wean people off substitutes for heroin. Will my hon. Friend discuss that with the Scottish Executive and bring the results of that experiment to their notice, so that they might use a drug that can get people off heroin and its substitutes?

David Cairns: I have heard our hon. Friend the Member for Bassetlaw (John Mann) speak about that initiative in his constituency. It sounds like a very exciting initiative that is worth studying. If the results are positive, I am sure that the Scottish Executive will wish to take a look at it. As for Afghanistan, the most recent findings from the United Nations Office on Drugs and Crime show that the production of the opium poppy, which has led to an increase in cheap heroin in the past few years, may be beginning to be reduced. Obviously, that is very welcome news indeed.

Labour Statistics

Jim Devine: If he will make a statement on employment levels in Scotland.

Alistair Darling: The number of people in employment in Scotland has increased by over 200,000 since 1997, and is currently at its highest level since quarterly records began. This shows the Government's success in bringing opportunity to all and has been achieved because of sound management of the economy working in combination with the enterprise policies of the Scottish Executive.

Jim Devine: Unemployment in my constituency is 2.1 per cent., but what further action will my right hon. Friend and the Government take to achieve the socialist utopia of full employment?

Alistair Darling: I certainly do not regard the concept of full employment as utopian, but when our right hon. Friend the Chancellor of the Exchequer said that one of his ambitions was to secure full employment, he was criticised by the Conservatives and other parties. The fact that many people are in work, which is bringing them opportunities of which they could only have dreamt years ago, is a tribute to the management of the economy. We intend to continue those policies, because that is the best thing to do for the benefit of Scotland and, indeed, the whole country.

Michael Weir: Despite what the Secretary of State said about employment levels, many manufacturers, particularly in my constituency, are seriously worried about the ever-increasing cost of energy. Over the next few months many of them will pay huge costs for their energy, and they are worried that that will impact on their ability to continue. What action has the Secretary of State taken to deal with the rising cost of energy, particularly for manufacturing industry?

Alistair Darling: The cost of energy is clearly of concern to a number of manufacturers, and we must make sure that we have a competitive supply of energy. The hon. Gentleman is not particularly in favour of that, but it is very important. It is also important, as we discussed a few moments ago, to do everything we can to ensure that we have security of supply, which also helps to bring down the price of energy. We will continue to ensure that those things happen for the benefit of manufacturing in Scotland and elsewhere.

Robert Smith: The Secretary of State mentioned that the Chancellor was keen on, and supportive of, full employment in Scotland. I should declare my interest in the oil industry, which appears in the Register of Members' Interests. One of the major contributors to the manufacturing economy of Scotland is investment in North sea exploration and production. Will the Secretary of State make it clear to the Chancellor that he must not impose on the North sea a windfall tax or other surprise taxation, which will frighten off the vital investment that is doing so much both for jobs in Scotland and for the security of our energy supply?

Alistair Darling: On full employment, I have just told my hon. Friend the Member for Livingston (Mr. Devine) that measures such as the new deal, which the Liberals opposed—to be fair, they were in favour of the concept, but against its funding—mean that hundreds of thousands of people are now in work and doing well in employment. That would never have happened but for the Government's policies.
	The North sea oil sector is doing well at the moment. Over the past 20 to 30 years, there have been many changes in the regime governing taxation, but I am confident that the Government will do everything that they can to make sure that the North sea oil industry continues to develop and expand, as that is extremely important, particularly for the economy of north-east Scotland.

Pensioners

Anne Begg: What estimate he has made of the number of Scottish pensioner households which will receive the £200 payment to help with council tax payments.

David Cairns: In Scotland, around 400,000 pensioner households with someone aged 65 or over and not in receipt of the guaranteed element of pension credit will receive the £200 age-related payment.

Anne Begg: I am glad to hear that. I do not know whether my hon. Friend is aware that the Liberal council in Aberdeen has increased council taxes for my constituents more than almost anywhere else in Scotland, so they will welcome that £200. What advice can he give my constituents when faced with high council tax hikes from the Liberal council?

David Cairns: My hon. Friend and I share the terrible burden of living in constituencies controlled by the Liberal Democrats at council level. At least hers does not have the distinction, which Inverclyde council has, of being the worst-performing council in all of Scotland since the Liberal Democrats took control. However, she is right that the £200 payment is part of a package of measures introduced by the Government to improve the lot of pensioners. Since we came to office, millions of pensioners have been taken out of poverty, which stands in stark contrast to the 18 years when the value of the basic state pension rose once and millions of pensioners were plunged into poverty under the Conservatives.

CONSTITUTIONAL AFFAIRS

The Minister of State was asked—

Electoral Registration

Andrew Selous: What her policy is on the use of national insurance numbers as an identifier in electoral registration.

Harriet Harman: Outside of Northern Ireland, we have no plans to require national insurance numbers to be required as a condition of electoral registration.

Andrew Selous: But if a presiding judge believes that the evidence of electoral fraud that he has seen would disgrace a banana republic, and also accuses the Government of being both complacent and in denial, why will the Government not introduce the tried-and-tested system of individual registration with national insurance numbers, which has worked so effectively to cut electoral fraud in Northern Ireland?

Harriet Harman: The hon. Gentleman refers to the comments of Richard Mawrey QC following his electoral court investigation into local government matters in Birmingham. We have gone through that judgment very carefully indeed. The 10 measures to increase security in elections that we have included in primary legislation, in the Electoral Administration Bill that is before the House, and the four measures that will be in secondary legislation arise from that judgment, so we have taken it on board and introduced primary and secondary legislation to address it. We will pilot individual identifiers because we want to test whether the increase in security that can come from stricter requirements as a condition of being on the register are not outweighed by a fall in registration. I have taken the opportunity of looking at the South-West Bedfordshire register. There is not a problem of under-registration there. The hon. Gentleman should be careful before he makes suggestions that would not be a problem on the register of electors in his area, but which might have catastrophic effects in areas where there is a shortage on the electoral register.

David Kidney: Does my right hon. and learned Friend accept that such a requirement would be a bureaucracy too far, would prevent and deter large numbers of electors from registering to cast their vote, and as such would be contrary to our wish for more people to participate in our democratic processes?

Harriet Harman: My hon. Friend is right. Commensurate with security that is as tight as possible so that we have confidence in the integrity of elections, we must ensure that more people are on the electoral register. The estimate is that about 3.5 million people who are entitled to vote are not on the electoral register and therefore are not able to vote. Those are not people in South-West Bedfordshire, but it should concern all of us that so many people are not registered. We do not want to create hurdles that result in even fewer people on the electoral register. We intend to pilot tougher security measures, but we must go about it on the basis of evidence and deal with it carefully.

Alan Beith: Since there is no agreement on national insurance numbers, will the Minister re-examine the transitional arrangements proposed by the Electoral Commission, under which a signature would have to have been lodged at the time of registration or later for anyone who wants to claim a postal vote? The postal vote could therefore be more effectively verified than under the present arrangements.

Harriet Harman: As the right hon. Gentleman knows because of his long experience and his excellent chairing of the Constitutional Affairs Committee, people who apply for a postal vote must provide their signature. Let me respond to him in a way that I hope other hon. Members will understand. The suggestion is that the collection of a signature should be voluntary when the application to register is made. I raise two questions with the right hon. Gentleman in response to that. First, if the scheme is voluntary, does it provide better security? Secondly, how would it be possible to encourage people to give their signature in such a way that it did not make them think the form was incomplete if they did not provide the signature, and at the same time encourage enough people to do it? My worry is that the proposal is a halfway house: it does not provide enough security; nor does it inhibit access. The House would agree that the way in which we are going about it—piloting in areas that can then be evaluated, so that we can increase security without that having a catastrophic effect on the register—is how we should go about dealing with the issue.

Michael Connarty: My right hon. and learned Friend does not want to use national insurance numbers, but security is a problem. Hopefully, we are all involved in a campaign to persuade our electoral registration officers to scour all available registers. I have corresponded with electoral registration officers from Lothian and Borders and from Central Scotland, who assure me that they go through all records, including council house tenancies. At that point, however, they send out a form, and there is no way to verify whether the people who fill it in are the people on the register, so security is still a problem.

Harriet Harman: My hon. Friend makes a good point, which is that even where electoral registration officers use data checking to discover whether somebody is actually present at an address in order to fill a gap in the register, they do not have the power to put them on the register and must still obtain a signature. He is right on that point, but it is still helpful when electoral registration officers check whether someone is present at an address. The Electoral Administration Bill requires electoral registration officers to use the available data, which some of them have not been doing. On fraud and data sharing, data matching and data checking mean that electoral registration officers can use existing data not only to ensure that gaps in the register are filled, but to check against fraud.

Peter Robinson: May I urge the Minister not to rule out the possibility of introducing national insurance numbers as identifiers in Great Britain? The policy has been more than piloted in Northern Ireland, where I believe that it worked—it provides accurate registers, which is an important factor. I do not believe that the Minister is right that it would significantly reduce electoral registration. The main problem in Northern Ireland was annual registration rather than the use of the national insurance identifier.

Harriet Harman: We listen carefully to the hon. Gentleman, given his experience in Northern Ireland. We have not ruled out the use at some future date of national insurance numbers as a condition of registration. Just as I expect him to know that I will listen to him on Northern Ireland—he knows about the electoral situation in Northern Ireland, the fraud, the duplications on the register and over-registration; I do not know about those things—I hope that he accepts that my hon. Friends and I know about our own constituencies, where sometimes up to 30 per cent. of the people who are entitled to vote are not on the register. Northern Ireland had a different set of problems, which was addressed by specific primary legislation, and we must introduce legislation in this country that suits all the different constituencies. We do not want to introduce legislation that works well in South-West Bedfordshire but has the catastrophic effect of disfranchising constituents such as mine.

Oliver Heald: Under-registration has been a scandal throughout this Government's period in office. Nothing has been done, and Labour councils are responsible for the areas concerned. What will the Minister do about under-registration and, equally importantly, accuracy, which is the point raised by the hon. Members for Linlithgow and East Falkirk (Michael Connarty) and for Belfast, East (Mr. Robinson)? The Electoral Commission and international observers have both said that we must have an urgent national response, not little pilots. Why has she not introduced individual voter registration? And why has she ignored the transitional scheme proposed by the Electoral Commission? She is kicking under-registration into the long grass, rather than tackling an urgent national problem.

Harriet Harman: I am not kicking it into the long grass—I am proceeding by way of pilots so that we have an evidence-based approach to policymaking. The hon. Gentleman implies that we are doing this too late. I shall not comment on that.
	As the hon. Gentleman says, it is important that we have an accurate register as proof against fraud; that is why we have introduced 10 measures in primary legislation and four in secondary legislation. We need to have it as proof against inadvertent inaccuracies; that is why we will have a central online record of electors and use data sharing. It is important not to be absolutist and ideological about this.
	Hon. Members on both sides of the House must surely agree that measures against fraud should be as tough as possible and that everybody who is eligible should be on the register. I hope that they accept that that is what, in good faith, my Department, my fellow Ministers and I are trying to do.

Community Justice Centres (Wales)

Huw Irranca-Davies: Whether she plans to establish community justice centres in Wales.

Bridget Prentice: There are currently two community justice projects—the pilot community justice centre in north Liverpool, which was launched last month by my right hon. and learned Friend the Minister, and the Salford community justice initiative, which will be launched next week. Those will be fully evaluated to determine aspects that can be applied elsewhere. There will be no further community justice centres such as that in north Liverpool until the evaluation has taken place at the end of 2006.

Huw Irranca-Davies: I welcome the approach to evidence-based policy that my hon. Friend is advancing. I urge her to consider the American example, where areas with community justice models were better at holding offenders accountable and had an improved community perception of local justice, a quicker process from arrest to court appearance, and reduced crime. While the evidence is being gathered, may I put in an early claim for community justice models in the Welsh valleys and other urban centres, where they will do a lot to restore faith in community justice?

Bridget Prentice: My hon. Friend makes a compelling argument for a community justice centre in his constituency or thereabouts. We will consider what happens not only in north Liverpool and Salford but in other projects around the country and internationally. There are good projects going forward in Bridgend in Wales, where county court staff give presentations to schools and bring young people into the court system to give them work experience. Those projects are receiving very good feedback. They are also excellent in bringing in people from black and ethnic minority backgrounds and have recently won a national award from Operation Black Vote for encouraging people from black and ethnic minority communities to become magistrates.

David Heath: Does the Minister accept that the experiment in Vauxhall in north Liverpool and the future one in Salford are enormously to be welcomed? Does she also accept—as I think she does, given what she said about evaluation—that the social and legal environment in the Red Hook area in New York, which was the origin of the experiment, is very different from that in northern Britain, let alone Wales, and that we need to look very carefully at whether the experiments work?
	One could say that the old-fashioned term for community justice centres is magistrates courts. Does the Minister agree that we need to ensure that every community in England and Wales has access to a magistrates court? Will she make it clear that the further proposals for rationalisation or closure of local magistrates courts play no part in providing a community justice system?

Bridget Prentice: The hon. Gentleman is right. We must consider community justice in the round. What is appropriate in north Liverpool may not be appropriate in Somerset, Wales or even central London. It is vital that we take such evaluations seriously.
	It is important that people have access to magistrates courts, but it is also important that we ensure that the proper facilities are available in the regions. I am sure that we will continue to ensure that that happens.

Jonathan Djanogly: The first such pilot centre was established in the England and Wales jurisdiction in December 2004. The Times described the position at launch as follows:
	"The court was scheduled to begin at 9.45 am but by 10.15 am no defendants had turned up. Judge . . . Fletcher . . . undeterred by the shaky start, conducted a brief adjournment hearing but was finally forced to retire in the absence of anyone to administer tough justice to."
	What lessons from existing centres can the Under-Secretary learn and apply to the new centres in Wales?

Bridget Prentice: It is a pity that the hon. Gentleman quoted from The Times instead of visiting the north Liverpool centre. We will help to arrange and facilitate that opportunity for him so that he can see the good work that is being done there.
	The court began operating from the Liverpool magistrates court in December last year and has already heard more than 1,300 cases. It is a doing a good job and we should appreciate its work. The court is working with the local community because it asked for that facility.

Tribunals Service

Tom Harris: What transitional arrangements are being made for tribunals that will join the Tribunals Service in 2006.

Bridget Prentice: A major programme of work is under way to prepare for the transfers. We are working closely with the tribunals, parent Departments and stakeholders to ensure a smooth handover. A team of about 40 staff is working on that. We are on target to complete the transfers by April.

Tom Harris: In my constituency, the efficiency of the asylum and immigration tribunal is vital. Will my hon. Friend reassure the House that the transitional arrangements will not compromise that efficiency, especially the average time taken for appeals to be heard against an initial decision to refuse asylum?

Bridget Prentice: My hon. Friend can be assured that immigration and asylum tribunals will not be affected by the transition because they are already part of the Department for Constitutional Affairs. He makes an important point about delay, which is not good, especially in asylum and immigration cases. The asylum and immigration tribunal, which started its work in April, now logs all cases directly. Those that are logged directly with it are often heard within a month of their being listed.

Keith Vaz: I had the pleasure of visiting the Arnhem centre last Friday and I saw the efficient work that is being done there. However, I am worried about appointments to the tribunals during the transitional period. Will the Lord Chancellor continue to make them or will responsibility be handed to the Judicial Appointments Commission, which already has a new chairman?

Bridget Prentice: I, too, have visited the Arnhem centre in Loughborough in the past couple of weeks. I put on record my thanks to the staff for their dedication. They work extremely hard and do an excellent job. Discussions are taking place about appointments in the transitional period. Those that are in the pipeline will continue to go through, but further discussions are being held with the different stakeholders to ensure that the transition is as smooth as possible.

State Funding (Conservative Party)

Nick Palmer: How much state funding has been paid to the Conservative party in the past five years.

Harriet Harman: In the past five years, including the current one, the Conservative party will have received approximately £22.5 million in Short money, Cranborne money and policy development grants. That figure does not include free postage and party political broadcasts.

Nick Palmer: The obvious question to ask is whether, at £100,000 per MP, the taxpayer is getting value for money. Perhaps more seriously, may I ask whether it is reasonable for the money to be concentrated overwhelmingly on one political party—be it the Conservative party or any other—and whether it should not be shared among the political parties represented in the House?

Harriet Harman: The figures are as follows: the Conservatives received £22.5 million; the Liberal Democrats will have received £9 million over the same period; and the Labour party will have received more than £2 million. The House decided that money should go to the Opposition parties in proportion to their size, and much less to the governing party.

LEADER OF THE HOUSE

The Leader of the House was asked—

Private Members' Business

Simon Hughes: If he will bring forward proposals to move private Members' business from Fridays to Wednesday evenings.

Nigel Griffiths: My right hon. Friend stated on 18 October that the Government had no plans to change the present arrangements for considering private Members' Bills.

Simon Hughes: At the moment, it appears to people outside the House that private Members' Bills have to overcome all sorts of hurdles before they have any chance of becoming law. If we are to engage the public and convince them that there is a chance for individual MPs to change the law, those Bills need a better slot and more protection. In the light of what happened to the Bills introduced by the right hon. Member for Birmingham, Ladywood (Clare Short) and, last Friday, the hon. Member for Southampton, Test (Dr. Whitehead), will the Deputy Leader of the House please reconsider bringing private Members' business into the middle of the week, where it would have the chance of a fair hearing and of making some progress?

Nigel Griffiths: Earlier this year, the Modernisation Committee considered moving private Members' Bills from Friday to a weekday evening. Its subsequent report concluded that such a move would fundamentally change the character of proceedings here, and the House has recently considered and decided the sitting pattern for the week. It is far too soon to reopen that issue.

Gwyneth Dunwoody: Will my hon. Friend carefully consider whether sufficient hours are allowed for private Members' Bills during the parliamentary week? There are ways in which the term could be extended. Members frequently come up with sensible ideas that ought to be allowed on to the statute book, but which are rejected by the Government of the day—sometimes for rather lightweight reasons.

Nigel Griffiths: There are 13 sitting Fridays for such Bills to be considered. The whole House will endorse my hon. Friend's sentiments in promoting the right of Members to have their Bills debated. When I have attended on Fridays, I have seen that there appears to be ample opportunity for debate, although, for one reason or another, best advantage is sometimes not taken of it. As I said, the Modernisation Committee considered this matter recently, as did the House in deciding our sitting patterns. I know that the House will want to review that matter from time to time as appropriate.

Chris Grayling: The Deputy Leader of the House will be aware that when Bills that have been fully debated in the House of Lords—often with the benefit of the great professional expertise in that place—come to this House, they often have to go to the back of the queue behind private Members' Bills, where they have little or no chance of being debated. Does he agree that that arrangement is not entirely satisfactory, and that it should be reviewed?

Nigel Griffiths: I do not agree with the hon. Gentleman. There are Bills that are drafted on behalf of Members in this House, which right hon. and hon. Members here would wish to champion. The hon. Gentleman would have difficulty in persuading hon. Members that their Bills should go to the back of the queue behind those from the other place, where there is ample opportunity—as he has pointed out—for the Lords to debate their Bills. Such matters are reviewed by the various Committees of this House and by Joint Committees, but I do not think that the hon. Gentleman has made a case for the change that he advocates.

Gordon Prentice: I support the hon. Member for North Southwark and Bermondsey (Simon Hughes). There are huge procedural hurdles to be overcome in getting private Members' Bills on to the statute book—100 Members voting for closure, for example. The whole pack of cards is stacked against private Members' measures. The Modernisation Committee is wrong; we have a slot available on Wednesday evenings, and private Members' Bills should fill it.

Nigel Griffiths: My hon. Friend is entitled to his opinion, and if he believes that members of the Modernisation Committee got it wrong, that is his view. As with several recent measures and decisions in the House, I respectfully disagree with him.

David Heath: I support the suggestion of my hon. Friend the Member for North Southwark and Bermondsey (Simon Hughes). Has the Deputy Leader of the House noticed that on occasions Members find an awful lot to say about private Members' Bills on Second Reading—perhaps rather more than they say on the Second Reading of a Government Bill? Is it time to have some protection, in terms of the length of speeches on Second Reading, to enable private Members' legislation to proceed? Would not it be sensible, in any case, for him to collate information from those Members who have the good fortune to be drawn out of the ballot about their experiences in proceeding with their Bills, so that we can amend the proceedings of the House accordingly?

Nigel Griffiths: I welcome that lengthy contribution and question from the hon. Gentleman. The position is clear: Members take as long as they feel is necessary. The way in which the House operates is considered at least annually, and the sitting pattern during the week was considered before the summer recess. All those factors are taken into account. We all read Hansard and draw conclusions about the qualities of speeches that we have and have not heard.

HOUSE OF COMMONS COMMISSION

The hon. Member for North Devon, representing the House of Commons Commission, was asked—

House Security

Graham Allen: If he will agree with the Royal Institute of British Architects the rules for an architecture competition to make the House more secure and more accessible; and if he will make a statement.

Nick Harvey: The Commission has no plans to sponsor such a competition. A range of schemes are in progress, however, to enhance access to the House and to improve security, including the new visitor reception building on Cromwell Green that is due to open late next year.

Graham Allen: I thank the House of Commons Commission for that typically helpful and radical answer. Will the hon. Gentleman consider putting the idea of arranging a contest to the Commission? Will he consider getting personally involved by sponsoring a prize, perhaps for the best school entrant's redesign of this Chamber? If he does so, I will personally sponsor a prize for the best student architect who comes up with a redesign of the Chamber. It is about time that we tried to inspire people outside to see this place once again as the forum of the nation rather than "behind the goldfish bowl".

Nick Harvey: I would be happy to sponsor a prize, as the hon. Gentleman suggests, for the best school entrant, but I caution him that he must be careful about raising any expectation that the winning design is likely to be put into practical effect. The Commission made it clear last year that the idea of visitors moving through a gallery to see the Chamber in action is not feasible, particularly in the current security climate. If he wishes to work up a detailed proposal, however, I am sure that the Modernisation Committee will be pleased to consider it.

Fair Trade

Peter Bone: What proportion of products served in the refreshment outlets in the House are fair trade products.

Nick Harvey: It is not possible to give a single overall figure in the terms of the hon. Gentleman's question. Eight fair trade products are sold on a permanent basis, and another 10 intermittently. I am pleased to tell the House that all freshly brewed coffee served by the Refreshment Department is fair trade coffee.

Peter Bone: I thank the hon. Gentleman for that reply. Should not we give a lead to the nation over fair trade products, which are very good? Surely the number of fair trade products available in the House is rather paltry, and should not we have a target for the availability of such products?

Nick Harvey: The fair trade product range is limited, and would therefore prevent us from reaching a high percentage. Many customers of the Refreshment Department exercise their choice, of which I am sure the hon. Gentleman would approve, by purchasing other products when fair trade products are available. Twenty-eight per cent. of the department's tea and coffee purchases in 2004–05 were fair trade. As he is aware, hon. Members can choose from a range of teas, and only a minority are currently taking advantage of fair trade products.

LEADER OF THE HOUSE

The Leader of the House was asked—

House of Lords Reform

Bob Spink: What recent discussions he has had with Cabinet colleagues on reform of the House of Lords.

Nigel Griffiths: My right hon. Friend the Leader of the House holds regular discussions with Cabinet colleagues on all aspects of the Government's programme, including House of Lords reform. The Government remain committed to the manifesto pledges to make further progress in codifying the conventions of the House of Lords and reviewing its functions, as well as placing reasonable limits on the time taken for consideration of Bills in that House. We also plan to remove the remaining hereditary peers, and to hold a free vote on the composition of the House.

Bob Spink: Does the Deputy Leader of the House regret the Government's dismantling of the other place without a viable plan to replace it? Does he accept that the natural, logical consequence of that Government action is that the other place will eventually become a wholly, or largely, elected Chamber?

Nigel Griffiths: I think that the hon. Gentleman is almost alone in believing that the Government have not made improvements in reform of the other place. Obviously many Members feel that those improvements have not gone far enough, but they are reflected in the manifesto that we put before the electorate, and we intend to follow them through.

BILLS PRESENTED

Pardon for Soldiers of the Great War

Mr. Andrew Mackinlay, supported by Chris Bryant, Paul Flynn, Jim Cunningham, Mr. Jeffrey M. Donaldson, David Taylor, Mr. David Chaytor, Jim Sheridan, Angus Robertson and Ms Katy Clark, presented a Bill to provide the granting of pardons to soldiers of the British Empire forces executed during the Great War of 1914 to 1919 following conviction for offences of cowardice, desertion or attempted desertion, disobedience, quitting post, violence, sleeping at post, throwing away arms or striking a superior officer; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on 2 December, and to be printed. [Bill 87].

Electoral Systems

Mr. David Chaytor, supported by Richard Burden, Mr. John Denham, Patrick Hall, Nick Harvey and Mr. David Heath, presented a Bill to provide for the holding of referendums about methods of election to the House of Commons and to local authorities; to enable a specified number of electors to require the holding of such a referendum; to require the Electoral Commission to establish a Citizen's Assembly to perform functions in relation to referendums; to provide for the adoption by a local authority of a different method of election; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 16 June, and to be printed. [Bill 88].

Point of Order

Eric Martlew: On a point of order, Mr. Speaker, concerning a statement on future infantry structure made in the Chamber on 16 December last year by my right hon. Friend the then Secretary of State for Defence, who is present today in a different role. He made an announcement about a new regimental name in the north-west. I was very pleased that he had retained the name "Border Regiment". Now I find that the Army Board, without reference to the Houses of Parliament—without reference to this Chamber—has decided to change the name. Surely that cannot be right, especially as the King's Own Royal Border Regiment has just been sent to Iraq. It is totally out of order for the board to change a decision made in the Chamber.

Mr. Speaker: I understand and sympathise with the hon. Gentleman's point, but he should understand that this is not a matter in which I can intervene. I am sure he will be able to apply for an Adjournment debate, which will allow the appropriate Minister to come to the House and give an account of what has happened.

Protection of Runaway and Missing Children

Helen Southworth: I beg to move,
	That leave be given to bring in a Bill to make provision for a national system to safeguard runaway and missing children; to make provision for the collection and reporting of information about runaway and missing children; make provision for co-ordination between local authorities and other bodies; and for connected purposes.
	Children who run away or go missing from home are not bad children; they are children in a bad situation, at very real risk of danger. They need us to act together to help sort out their problems and keep them safe. We know the high risk that lone children face, yet we do not know how many children are reported missing to the police nationally, where they are missing or where they go. We do not have the information that we need to direct resources to deal with a critical and very complex issue.
	The most comprehensive information that we have is from studies conducted by the Children's Society and the National Missing Persons Helpline, both of which are charities. The Children's Society undertook a new national survey of young people in the first half of 2005, involving more than 11,000 young people aged between 14 and 16 in mainstream schools, special schools and pupil referral units in 25 areas of England. The findings were stark. An estimated 100,000 young people under 16 run away or are forced to leave home to escape problems, while 77,000 children are running away for the first time each year.
	The reasons for leaving home or care are very varied. Some young people are testing the boundaries, or find it difficult to negotiate and resolve difficulties in their families. Some have experienced bullying and a high level of conflict. Some are escaping abuse, neglect and danger. A quarter of young runaways said that they were forced to leave home and two thirds of children running away overnight were not reported missing to the police on the most recent occasion of going missing. Those findings are consistent with a smaller study conducted by the Children's Society in South Yorkshire and with evidence taken from the United States.
	One in six runaways slept rough while they were away. If extrapolated, that means more than 10,000 children aged between 14 and 16 are sleeping rough every year in England alone. The risk of being hurt or harmed increases with the time spent away from home. Children who were away for a week or more were twice as likely to have been harmed as those away for just one night. Only a fifth of children sought help from anyone while away from home.
	The university of York studied children who had used Message Home—the National Missing Persons Helpline 24-hour service—and found that while four fifths of those questioned had run away, one fifth reported that they had been forced to leave. The majority had gone missing from their family home, with a quarter reporting abuse and nearly a tenth bullying or other school problems. Many of those who had run away had stayed in very risky environments. Almost a third had stayed with a stranger, and more than two fifths had slept rough.
	In the York study, one in eight reported having been physically hurt and one in nine reported having been sexually assaulted while away. Young people reported feeling unsafe or frightened while staying with strangers. Some stayed with adults whom they thought were friends only to be subject to abuse and placed at risk. The report concluded:
	"It is difficult to over estimate the degree to which young people are vulnerable to exploitation when they are away from safe adult care".
	Some young people have horrifying and very dangerous experiences that would test the courage and resilience of anyone in this Chamber—and the impact can be felt for many years.
	Crisis, the charity for single homeless people, argues that research shows that children who run away are more likely to become homeless in later life. Crisis believes that it is important to intervene as early as possible to prevent runaway children from settling into a homeless lifestyle. The circumstances in which young people run away or are missing from home or care can be distressing, frightening and dangerous. It is difficult for the police and local authorities to predict the risk in individual cases.
	Huge improvements have been made in children's services since the Children's Society set up the first UK refuge for runaway children in 1985. The social exclusion unit reported on young runaways in November 2002 and the Department of Health statutory guidance issued at the same time places requirements on local authorities to establish joint protocols to co-ordinate joint working across all agencies—including police, social services and health—for children who go missing. Each authority must have a senior manager to oversee those protocols and their implementation, and must produce an annual strategic monitoring report.
	Part of the complexity of supporting children who have run away or are missing from home is that many children do not stay close to home. In my constituency, for example, they could be in the major cities of Liverpool or Manchester within 40 minutes of leaving home, crossing several local authority and police boundaries in the process. Police boundaries are rarely coterminous with those of local authorities.
	The Association of Chief Police Officers has published guidance this year on the management, recording and investigation of missing persons, with standardised data collection requirements and case management procedures. For the first time, there are national standards to work to and forces can be inspected on them. However, the guidance does not yet have the status of a code of practice, and does not yet have the IT infrastructure to underpin the reporting requirement. Indeed, some police forces are still using paper-based systems, making information sharing very labour intensive. ACPO has developed protocols and IT systems with the National Missing Persons Helpline and the Home Office has agreed to make the IT systems available to forces at cost.
	The Bill will establish a requirement for a single comprehensive national database and for the reporting of information to enable effective planning, to identify   trends and to inform service commissioning and the sharing of best practice. There is no national co-ordination in place for providing services to young runaways—despite the very clear fact that running away is an act that can take children and young people across local authority and police boundaries and right across the country. The UK Police National Missing Persons Bureau, which conducted a strategic review earlier this year, could play a key role in managing data, running briefs and debriefs on critical incidents, and providing information for the commissioning of local and strategic services. But it needs a clear remit, and to be properly resourced as part of a national strategy.
	Voluntary organisations are providing very important support services for vulnerable children, some of whom do not relate to, or feel intimidated by, statutory services. Some of these organisations are strategic service providers such as the Children's Society and the National Missing Persons Helpline, but a wide range of charities and non-governmental organisations also play a vital role supporting runaway and missing children and young people. In my constituency, "Talk Don't Walk"—a new, local charity-managed joint partnership project with the police, the local authority, health services, Connexions and the voluntary sector—is having a significant impact on reducing incidents of running away. Early this year, it worked with children in local authority care and their care staff to deal with issues of concern to them, and to prevent them from needing to push the boundaries by running away. The number of runaway incidents was cut from 83 to 39, and overnight episodes were cut from 67 to just one. On the basis of Home Office figures, which state that an overnight episode costs more than £1,400 on average, the total saving in terms of service resources was in excess of £78,000, but the saving in anxiety, risk and danger to those young people was far greater.
	There are a significant number of local and national agencies and departments whose activities and responsibilities need to be brought together to support vulnerable children who are susceptible to running away. Advice and counselling, and help with negotiating boundaries and managing relationships, could assist such young people in finding alternative strategies to deal with problems at home and in school.
	We need a national overview of projects working with missing children, so that we can learn what works best and roll out best practice. We also need a strategic body to commission or purchase cross-boundary services such as a nationally accessible 24-hour helpline; an appropriate number of children's refuges; and safe, supported accommodation. The National Missing Persons Helpline is dependent on donations, grants, charity shops and volunteers for its survival. The Children's Society's "safe and sound" campaign has highlighted the fact that there are only three children's refuges in the UK, offering a total of just 10 beds. Moreover, Government funding for the two runaway refuges in England will end in March 2006.
	This Bill will establish a requirement for the national collection and reporting of data on children reported missing to the police, and a requirement for a regular national survey of young people similar to the British crime survey, in order to identify under-reporting. With co-ordinated leadership from national Government, it will also establish a national co-ordinating body that will include key statutory and voluntary agencies, in order to develop integrated policy and service provision.
	We need to do this to protect vulnerable children, and I commend the Bill to the House.
	Question put and agreed to.
	Bill ordered to be brought in by Helen Southworth, John Battle, Ann Keen, Rosemary McKenna, Liz Blackman, Dan Norris, Ms Dari Taylor, Paddy Tipping, Laura Moffatt, Kitty Ussher, Peter Bottomley and Mr. Paul Burstow.

Protection of Runaway and Missing Children

Helen Southworth accordingly presented a Bill to make provision for a national system to safeguard runaway and missing children; to make provision for the collection and reporting of information about runaway and missing children; to make provision for co-ordination between local authorities and other bodies; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on 12 May, and to be printed [Bill 86].

Opposition Day
	 — 
	[9th Allotted Day]

NHS Finance

Mr. Speaker: I inform the House that I have selected the amendment in the name of the Prime Minister.

Andrew Lansley: I beg to move,
	That this House supports the provision by the NHS of comprehensive, high quality health services, based on need and not ability to pay; notes that, despite unprecedented resources provided to the NHS, NHS trusts were over £600 million in deficit in 2004–05 and predicts deficits approaching £1 billion this year; believes that these deficits threaten the delivery of NHS services, through service cuts, freezing of staff vacancies and redundancies, bed closures and the closure of services in community hospitals; further believes that the uncertainty caused by proposed primary care trust restructuring should not be used to obscure responsibility for financial recovery and service continuity; wishes to see resources reach front-line healthcare providers; regrets the lack of savings in NHS overhead and administration costs; and calls on the Government to intervene to ensure that the long-term interests of patients are not damaged by short-term financial decisions.
	At the heart of the debate is a series of questions. Why, when the Government are spending unprecedented amounts of money on the NHS, are more NHS hospitals and trusts in deficit? Why are services threatened? Why are jobs being lost, and why are community hospitals closing?
	In this debate, we will investigate why those things are happening. What are the consequences? We will argue that the long-term interests of the NHS and patients must not be sacrificed to short-term financial decisions.
	Let us start with the facts. In the financial year 2004–05, 90 primary care trusts, 65 NHS trusts and a number of NHS foundation trusts—the total has yet to be declared, but I believe it to be 12—were in deficit. The combined deficits amounted to £630 million, even though the Department of Health set control totals in the latter stages of the 2004–05 financial year to limit the overall deficit.

Stephen Hesford: Will the hon. Gentleman give way?

Andrew Lansley: I want to get the facts on the record, and then I shall give way.
	The Department of Health aimed for a control total of £70 million. Three months after the end of the financial year, the Secretary of State was questioned on this matter and told the House that the net NHS deficit was £140 million. Despite pressure from Opposition Members, she did not acknowledge or admit that total overspends amounted to more than £700 million.
	Shortly after the Secretary of State admitted that the net deficit was twice as large as the control total, the permanent secretary at the Department of Health revealed that the net deficit was £250 million. The figure would have been much higher but for the fact that strategic health authorities had underspent their budgets by some £372 million. To do that, I understand that they raided the budgets of the work force development confederations—the very same budgets that the Labour party, in the general election campaign, accused the Conservatives of wanting to abandon as part of our proposals to scrap SHAs.

Stephen Hesford: The hon. Gentleman quoted a figure of £600 million. The NHS Confederation reckons that the net figure is nearer £250 million. How does he account for the difference?

Andrew Lansley: The hon. Gentleman clearly believes the Government's propaganda. I have just explained all this, but I shall do so again. The net deficit in the NHS was just over £250 million because SHAs underspent their budgets—a large part of which was to be devoted to the work force development confederations—by £372 million. Without that underspend, the deficit across the NHS would have totalled £630 million.

Stephen Hesford: Will the hon. Gentleman give way again?

Andrew Lansley: I will, and perhaps this time the hon. Gentleman will explain why Arrowe Park hospital is facing deficits and closing beds.

Stephen Hesford: I shall deal with that when I come to make my speech, but I can tell the hon. Gentleman that he is wrong—[Interruption.] Mr. Speaker, the Opposition do not want to listen. However, when the hon. Member for South Cambridgeshire (Mr. Lansley) quotes a figure of £600 million, is he not simply exaggerating?

Andrew Lansley: There are limits to how many times I can repeat the same figures, even if the hon. Gentleman simply fails to understand them. If he comes to a debate on NHS finance, he should at least take the trouble to understand the subject. The Secretary of State will admit, if she cares to, that the gross overspends reported in the NHS accounts—and I can go through them for the hon. Gentleman, if he wishes—were £630 million. If the right hon. Lady wants to deny that figure, I shall give way to her now. [Hon. Members: "Come on!"] As I expected, the Secretary of State makes no move to respond. Let us get some more facts on the record.
	Three years ago, six SHAs were in deficit overall. Two years ago, seven SHAs were in deficit, and last year the total was 12. Half way through this financial year, 21 out of 28 SHAs were predicting deficits. The hon. Member for Wirral, West (Stephen Hesford) seems fond of quoting the NHS Confederation. In its otherwise obfuscatory briefing, it did at least admit that deficits this year are expected to be worse than last year.

Michael Penning: If the Secretary of State and Opposition Members do not believe our figures, perhaps they will believe Unison's. My friends at Unison have supplied us with a nice document that tells us that the deficit is £200 million in the eastern region alone. Unless the rest of the country has a tiny deficit, someone is telling porky-pies.

Andrew Lansley: I am grateful to my hon. Friend for that point. Indeed, in Norfolk, Suffolk and Cambridge, the strategic health authority predicted a £92 million deficit in its area alone.
	Two years ago in 2002–03, there were 71 deficits. In 2003–04, there were 106 deficits and by 2004–05 there were 167 deficits, including foundation hospital trusts. As I said this year, the projected deficit is £1 billion, far in excess of last year's. The Department of Health has already set control totals approaching £350 million, but one has little confidence in its ability to exercise financial control. The chief executive of the Department, in a memo leaked last week to the Health Service Journal, said that the NHS is
	"tightening financial discipline after a spurt of growth in which increased income sometimes allowed people to forget good financial discipline."
	That is from the accounting officer for the Department of Health. It is little wonder that three months after the end of the financial year the Secretary of State could be nearly 100 per cent. out on the out-turn figures for NHS finances.
	NHS trusts have a statutory duty to break even, which is generally interpreted as allowing one financial year to be taken with another, but at this rate they will have to put two or three financial years together. We are now in the fourth year of rising deficits. Many PCTs and trusts have breached their requirements to live within resource limits or external finance limits. In several parts of the country, there is a risk of financial collapse.

Tim Yeo: Is my hon. Friend aware that Suffolk West primary care trust proposes savage cuts in my constituency, including the closure of Walnut Tree and St. Leonard's hospitals in Sudbury with the loss of 68 beds? The cuts will be made at a time when Suffolk county council's social care budget is under extreme pressure and facing cuts, the population of the town is increasing sharply and beds in West Suffolk hospital—the district hospital that serves the area—are also being cut. The PCT's announcement of the cuts came just three months after it had approved the construction of a new replacement community hospital in Sudbury, the announcement of which came—conveniently—just before the general election. Today, Sudbury's existing hospital is to be closed, its new hospital has been cancelled and no replacement community services will be in existence before the cuts are made.

Andrew Lansley: I know that my right hon. Friend has been an active and tireless advocate for his constituents on the issue of Walnut Tree and St. Leonard's hospitals. The PCTs in Suffolk suffered large deficits. If memory serves, Suffolk Coastal and Suffolk West PCTs together were £18 million in deficit. As I said to my hon. Friend the Member for Hemel Hempstead (Mike Penning), Norfolk, Suffolk and Cambridge together face a very large deficit. The risk of financial collapse certainly applies to the Suffolk health economy and my right hon. Friend is right to be concerned about it.

Peter Ainsworth: While discussing the terrible deficits that have built up around the country—the Surrey and Sussex trust has an accumulated deficit of some £67 million—will my hon. Friend also reflect on the fact that the problem is not only about numbers? It is about cancelled operations and personal anxiety. It is about people having to make inconvenient travel arrangements to go further afield for their operations. It is about human misery and a failing health service. No number of letters from the Surrey and Sussex strategic health authority saying that it has been a huge success since its formation will persuade people who are suffering under this Labour Government that the health service is not in meltdown in Surrey.

Andrew Lansley: My hon. Friend is right: his area, Surrey and Sussex, has serious financial problems and he is right to say that they will manifest themselves in harm to patients. That is precisely why we say to the Government today that before the consequences of their decisions are played out in this financial year action must be taken to avoid damage to patients and indeed to their long-term interests, because often the services being cut could be part of a sustainable and successful long-term health system.

Kali Mountford: The hon. Gentleman is setting out for the House his view of the facts, but will he look at some other facts? For example, when the previous Conservative Government introduced the private finance initiative why were no hospitals built? Can he explain what the impact of the expenditure was when they actually were built, and will he explain why the hospital in Halifax was not built for more than two decades? Is he now suggesting that the hospitals that were built should not have been built?

Andrew Lansley: Given that the first flagship hospital to be built under the Government's PFI scheme was in Norwich, the hon. Lady might like to ask her colleagues there about the financial consequences of the way in which that project was undertaken. I know that we needed to build hospitals and it is right to do so, but to do it, as the Government did, in a way that transferred little risk but large amounts of profit through PFI, is not necessarily the right way.

Edward Balls: Like many Labour Members, I am pleased that Opposition Members are now concerned about standards of patient care and the financial state of the NHS, but if my memory serves me right, £2 billion would have been diverted from NHS trusts by the manifesto that all Opposition Members supported, through the patient's passport. Was that the right policy? Did the hon. Gentleman support it then, and why does he not support it now?

Andrew Lansley: I thought we would get something better from the hon. Gentleman.

Julie Kirkbride: I want to help my hon. Friend by responding to the remarks made by the hon. Member for Colne Valley (Kali Mountford). In my constituency, we face cuts of between £20 million and £30 million at our local hospital, which threaten the accident and emergency department. One of the factors that makes it difficult to balance the books in Worcestershire's health economy is the cost of the PFI hospital in Worcester, one of the first hospitals to which the Government signed up. In the words of the chief executive of our local trust hospital, the hospital is "relatively expensive". When I heard the Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint), talking about the Worcestershire acute trust this morning, it occurred to me that there might be some panic in the Department of Health about the true cost of the PFI hospitals to which the Government have signed up.

Andrew Lansley: rose—

Mr. Speaker: Order. I appeal to Members to make brief interventions, not long speeches.

Andrew Lansley: I am grateful, Mr. Speaker. I am also grateful to my hon. Friend the Member for Bromsgrove (Miss Kirkbride), who made an important point. I visited Redditch hospital and I know how important it is to the people of Redditch and the surrounding area that they have access to services, including the accident and emergency service at the hospital.

Several hon. Members: rose—

Andrew Lansley: I want to make some progress, but I will give way to my hon. Friends in a moment.
	As my hon. Friend the Member for East Surrey (Mr.   Ainsworth) said, we need to think about the consequences—

Edward Balls: rose—

Andrew Lansley: What are the implications of those deficits?

Edward Balls: rose—

Mr. Speaker: Order. The hon. Member for South Cambridgeshire (Mr. Lansley) is not giving way.

Andrew Lansley: Important as it is to understand the finances of the NHS, it is more important to understand the consequences of the deficits. In September, the British Medical Association conducted a survey, which found that three quarters of trusts faced a funding shortfall; one in three trusts were planning to reduce services and almost half were freezing recruitment, including the recruitment of medical staff. A quarter of the trusts were considering redundancies, including medical staff—for example, clinical psychiatric staff in Oxfordshire.
	The BMA said:
	"Something is going terribly wrong when patients pay the price for those financial problems and the Government's lack of joined-up thinking".

Gregory Barker: My hon. Friend may be interested to know that patients are already paying a price in East Sussex. In the East Sussex Hospitals NHS Trust, which is almost £5 million in deficit, not only two weeks ago did Conquest hospital start closing wards ahead of the winter, but it has now told all new out-patients that no one will be seen this side of Christmas and that patients must travel up to 30 miles. That is a damning indictment of not just the current financial crisis but a health funding formula that diverts funds from constituencies such as mine in the south-east to Labour's friends in the north.

Andrew Lansley: Yes, I understand exactly the point that my hon. Friend makes. South Cambridgeshire primary care trust, which covers most of my constituency, gets £888 per head this year, while the PCT in the Secretary of State's constituency gets £1,131.
	The Royal College of Nursing published a survey this month that showed that up to 3,000 staff in England would lose their jobs, including at least 1,000 nurses.

Ian Austin: Given the hon. Gentleman's complete failure to answer the question posed by my hon. Friend the Member for Normanton (Ed Balls), may I ask him again whether he supported the patient's passport and the Conservative pledge to remove £2 billion from the NHS at the election? [Interruption.] I recall Conservative Members voting against the national insurance increase that has delivered billions of pounds for the health service. Will he tell me what the effect of blocking that increase would have been on NHS finance?

Andrew Lansley: Those who observe or read the report of the debate will reflect on the fact that Labour Members are not prepared to stand up and defend their Government's policies.
	We are in the business of examining what is going on in this financial year and what are the realities across the NHS. One of the realities of those deficits is the closure of NHS beds. Let me remind the Government. The Secretary of State will recall, no doubt, that the NHS plan said five years ago that there would be 7,000 extra NHS beds by 2004. In fact, between 2000 and 2004, the number of NHS beds fell by 4,518.

Bob Spink: Does my hon. Friend share my concern that, during the Labour Government's term in office, 111 beds have been cut from Southend and Basildon hospitals, which serve my constituency, and that the Minister responsible refuses to give me an undertaking to rule out further cuts in hospital beds there?

Andrew Lansley: My hon. Friend gives a figure above and beyond the numbers that we have been able to establish in the survey that we have undertaken of possible bed closures across the country. That figure adds to those that I was about to give the House.

Geoffrey Clifton-Brown: As my hon. Friend knows from his excellent visit to Tetbury hospital, four cottage hospitals in my constituency face severe cuts. Is he aware that the Government made two fundamental pledges in their manifesto at the last election: to strengthen our national health service and to increase the number of intermediate care beds? Is it not about time that the Government allocated whatever resources they have got for the health service more fairly?

Andrew Lansley: Yes. I did indeed visit Tetbury hospital in my hon. Friend's constituency. Given the valuable work done there and the opportunity for patients to be sent closer to home for further rehabilitation after operations, in refurbished and well-appointed small wards, I was astonished that the PCT proposes to close them at the end of December. That seems outrageous and he was right to receive a substantial local petition on the subject.
	I want to pick up the thread of where we are with the number of beds. Our analysis—clearly, the figure is greater than we knew—is that 2,500 additional NHS beds are threatened with closure this year in the 43 trusts that we identified from our survey. In the five years since the publication of the NHS plan, instead of 7,000 more hospital beds, there will be 7,000 fewer. Five years ago,we had 186,000 beds in the NHS and 159,000 administrators. By the end of this year, we will have fewer than 180,000 NHS beds, yet more than 211,000 administrators.
	What has been going on? Why have these deficits occurred? It is partly because the Government have been decreeing the cost structure of the NHS and costs have been rising dramatically. About 80 per cent. of the additional cash provided for the NHS has been consumed by spending pressures: pensions indexation; National Institute for Health and Clinical Excellence guidelines; the consultants' contract, the cost of which the Government underestimated; the general practitioner contract, the cost of which was substantially underestimated; the drugs bill; and the implications of the working time directive, which means that many more medical staff must be employed to undertake the same work as previously. Additionally, £500 million extra has been spent on "Agenda for Change" and information technology costs have been higher than predicted. I am reliably informed that, if the NHS tariff had had to incorporate all the additional spending pressures last year, it would have increased by more than 8 per cent. All the extra cash thus would not have bought anything extra, which is interesting because that is precisely what happened. We had all the extra cash, but there was no increase whatsoever in the number of elective operations—that is, planned operations—carried out in NHS hospitals between 2003–04 and 2004–05.

Grant Shapps: Has my hon. Friend included in the category of wasted money the amount spent on consultants? My East and North Hertfordshire NHS Trust recently called in an outside consultancy firm at a cost of more than £300,000. The upshot was a recommendation to close the children's accident and emergency department, the blue light A and E service that is for everyone, all maternity services and all facilities for elective operations. The general hospital has been turned into nothing more than a community hospital. That is where the money is going.

Andrew Lansley: I have every sympathy with my hon. Friend. We visited that hospital together and I entirely understand his point.
	Management should be effective. Monitor has employed some management consultants and, frankly, that spending represented better value for money than the amounts spent year after year on the strategic health authorities that are supposed to be responsible for performance and financial management in the NHS, but have palpably failed to deliver on that responsibility. Under the Government, we get more management, but not better management. There are now 52,000 more administrators than there were not in 1997, but in 2000.

Jim Cunningham: Does the hon. Gentleman recall that one reason why we had hospital closures was the lack of investment in doctors and consultants and the fact that nurses were made redundant? More importantly, he is missing this point: we do not hear about many cases of people on trolleys because there are no beds for them in hospitals any more.

Andrew Lansley: We are debating the NHS as it is today, not the hon. Gentleman's representation of how it might have been in the past.

Kali Mountford: rose—

Andrew Lansley: I have more to say and I do not want to intrude on the time of hon. Members who want to speak.
	In four years, the number of administrators has increased by a third, which is twice the rate of increase in the number of doctors and nurses. The cost of salaries for administrators—not the other bureaucratic costs imposed on the system—rose over those four years by £1.3 billion in real terms. However, half that amount represents the deficit in the NHS. If the cost of bureaucracy in the NHS had been held down over the past four years, the money would have been available to enable many of the deficits to have been met and avoided.
	As my hon. Friends have made clear, the consequences of the situation for community hospitals are dramatic. We have a list of 90 community hospitals that are threatened. However, the Government said during the election that they wanted to build new community hospitals. The NHS plan said that they wanted more intermediate care beds, but community hospitals and intermediate care beds are being closed.

Ann Winterton: Is my hon. Friend aware that it is not only community hospitals that are under threat? I am the greatest supporter of community hospitals, and the Congleton War Memorial hospital gives a fantastic service, but district general hospitals are now under threat. If accident and emergency, children's and maternity services are stripped away from a district general hospital, one has only a community hospital. I represent a rural area from which people will have to travel to Stockport, Leighton and north Staffordshire for treatment. Given that the Government are trying to get us all off the roads, does he agree that that seems stupid?

Andrew Lansley: I do agree. My hon. Friend will no doubt know—I cannot see any Members of Parliament from north Staffordshire here at the moment—of the difficulties that the university hospital at north Staffordshire itself faces and the threat to services there.
	The issue of community hospitals is a classic illustration of precisely the point of this debate. Primary care trusts that are running deficits are trying to deal with the implications of payment by results and paying for the activity in hospitals—principally the emergency and unplanned activity—while at the same time having to pay enormous amounts through the GP contract. Their solution is to cut the budget of the one part of the scene that they control. That is often the contracts with community hospitals. That is fool's gold—it is penny-wise and pound-foolish—because in the longer run, we will have less accessible services and less appropriate services clinically. Patients should be discharged from the acute district general hospitals to relieve pressure there and would be seen more appropriately in community hospitals.

Nick Hurd: My hon. Friend may be aware that Hillingdon primary care trust forecasts a deficit of £31 million in 2005–06. It admits that the only solution is substantial closure of beds at Hillingdon hospital. In the meantime, it tinkers with cuts to services which, in its sensitive way, it deems low priority, but which are highly valued by those who are about to lose them. Are my constituents wrong to feel angry at the amount of time and money that the same strategic health authority spent on the Paddington health campus fiasco?

Andrew Lansley: My hon. Friend is right: his constituents should feel angry at the fact that £14 million has been wasted on consultancy and the like on the Paddington health campus scheme. In addition, the National Audit Office report suggested that the opportunity cost of that scheme was £100 million. Where was the statement from Ministers? Which Minister told the House about that? The Minister formerly responsible for that, the new Secretary of State for Work and Pensions, did not even have the courage to give an interview to the independent review into the Paddington health campus scheme, such is the complete absence of accountability on the part of this Government.
	I want to mention two more things. Is there any answer to all this in the primary care trust restructuring that the Government have proposed? There is no answer at all. We know what is really going on. There are deficits and difficult, sometimes painful and wrong-headed decisions to be taken, often without the benefit of realistic or real consultation with local people, but lo and behold, in a year or two, all the organisations that take those decisions will disappear and be submerged into a bigger organisation. There is everything to be said for cutting bureaucracy in the NHS—we recommended that, but we were clear at the time of the election about the future functions of PCTs. This Government—I do not know where the Secretary of State was when the announcement was sent out, for which she has apologised—dictated changes in the form of primary care trusts but at no point said what their functions would be. There has been utter confusion since.

James Gray: Will my hon. Friend give way?

Andrew Lansley: I will give way for the last time to my good friend and then I must conclude.

James Gray: My hon. Friend is right about the re-creation or re-amalgamation of PCTs. In Wiltshire, we have re-created something that looks very much like the Wiltshire health authority, which I rather welcome, but on top of that we have something called the Avon, Gloucestershire and Wiltshire strategic health authority—what it is for, I know not—which spends huge sums on bureaucrats, all of them driving BMWs, and on a posh office in my constituency. What is happening? They are closing Malmesbury hospital as a result—closing a hospital to spend the money on admin.

Andrew Lansley: My hon. Friend is right.
	We have a great deal to do. We need to cut bureaucracy. We need proper risk-sharing agreements between PCTs and hospitals about what is to be done where activity rises and payment by results applies. We need integrated commissioning of emergency care. We need the Government to stop the central imposition of costs through national pay contracts. The working time directive needs to be renegotiated. More than a year ago, the Government promised to renegotiate it in Europe, but we have not heard anything about it since. Most of all, however, we need a Government who do not believe that, while controlling NHS costs and imposing 80 per cent. of the additional cost pressures on primary care trusts, they can at the same time wash their hands of that responsibility which, they say, belongs to local PCTs.

Patrick McFadden: rose—

Andrew Lansley: I am afraid that I am about to conclude.
	The Government must not be allowed to wash their hands of the deficits that have arisen across the NHS. Resource allocation means that health economies in London, as we heard from my hon. Friend the Member for Ruislip-Northwood (Mr. Hurd), in the south-east, parts of the south-west, East Anglia and parts of the north are in crisis. Hospitals across the country are struggling with rapidly rising cost pressures. Rising emergency attendances are crowding out elective activity in NHS trusts. At the same time, however, the Department of Health top-slices funds for take-or-pay contracts with private sector providers, who are paid regardless of whether patients are referred to them.
	Unrealistic and absurd assumptions by Ministers have led to serious underestimates of the cost of consultant and GP contracts. A former health adviser to No. 10 says that too many Government contracts did not incentivise productivity improvements. Small wonder, then, that productivity in the NHS declines every year. PCTs are caught between the rock of rising hospital costs and the hard place of GP contracts and out-of-hours costs. PCTs are cutting services and closing community hospitals and mental health services, as has happened in my own constituency, thus threatening the long-term viability of community services. Short-term cuts threaten the long-term interests of patients. Instead of shifting the blame, the Government must recognise the scale of the problem, intervene to resolve the deficits, and prevent permanent damage to the NHS this year and next. I commend the motion to the House.

Mr. Speaker: I remind the House that there will be an eight-minute limit on Back Benchers' speeches.

Patricia Hewitt: I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
	"welcomes the Government's record levels of investment in the National Health Service, with expenditure set to rise to over £92 billion by 2007–08; notes that by this date £70 billion, more than ever before, will be going to the NHS front line; congratulates the Government on delivering investment and reform, leading to historic improvements to NHS services and capacity, reducing waiting times to their lowest in nearly a generation, from over two years to a maximum of six months, and to a maximum of 18 weeks by 2008, employing nearly a quarter of a million more NHS staff than in 1997, including 78,700 more nurses and 27,400 more doctors, and undertaking the largest hospital building programme in the history of the NHS, including investing £100 million in a community hospitals programme; further notes that the NHS has achieved overall financial balance in each of the past four years, and last year carried a deficit of around only 0.4 per cent. of total resources; compares this with the record of the previous Government which left the NHS with a £460 million deficit in 1996–97 which amounted to almost 1.5 per cent. of total resources; and agrees that, given the record increases in health funding available coupled with the strengthening of Primary Care Trust commissioning, all NHS organisations should be able to live within the resources available to them and to provide excellent services to their populations."
	This morning, I had the enormous pleasure of accompanying my hon. Friends the Members for East Ham (Mr. Timms) and for West Ham (Lyn Brown) to the official opening of the NHS gateway treatment centre in Newham, which is one of the most diverse communities in the country, with the UK's youngest population. It also has some of the most pressing health needs. Now, however, the new NHS treatment centre, which is part of the growing Newham health village, is offering outstanding care to NHS patients. There is a wonderful new environmentally sustainable building, which is the result of a £17 million investment with which we helped. The centre offers patients the choice of three-bed ward or a single-bed room. It was designed with clinicians to speed up care and recovery.

Graham Stuart: Will the Secretary of State give way?

Patricia Hewitt: No, I will finish my example before giving way. I know that the hon. Gentleman has received excellent health care and will readily give way to him in a moment. [Interruption.] If Opposition Members will permit me, I want to say a little more about what the staff at the gateway centre are doing. It was a pity that the hon. Member for South Cambridgeshire (Mr. Lansley), who spoke at some length, did not give one word of thanks to our outstanding NHS staff.

Andrew Lansley: The Secretary of State knows perfectly well that this whole debate is in the interests of NHS staff. However, I would like to pay tribute to the staff of hospitals in Newham, because Newham general hospital is the successor institution to the East Ham memorial hospital, where my father ran the pathology laboratory for nearly 30 years.

Patricia Hewitt: I am glad that the hon. Gentleman has now made that point. The staff at the Gateway centre, led by the consultant surgeon Mr. Nigel Fieldman, are working in new and better ways. They are making much greater use, for instance, of nurse practitioners and operating department assistants. The result is that a patient coming in for a hip replacement or some other elective procedure, who, in the old hospital, would have faced an average stay of 10 days, now has an average stay of just five days, and the staff believe that they can get that down even further.

Several hon. Members: rose—

Patricia Hewitt: Before I give way, I want to pay tribute to the outstanding work of all the staff at the Gateway centre, but in particular to Mr. Fieldman, who is due to retire shortly and will leave behind him a centre that is a shining example of the future of our national health service.
	I will give way first to the hon. Gentleman with the injury.

Graham Stuart: Some hon. Members may have noticed that the sling was off last week. I was a poor patient and had to put it back on this week. I am delighted to hear of the reaction of staff in Newham at being provided with decent facilities with which to look after their patients. We only wish that were true across the country. We wish that the right hon. Lady would speak to the staff in Withernsea and Hornsea in my constituency and tell them about decent facilities. They want them there so that people can have better care in east Yorkshire, not just in central London.

Patricia Hewitt: It is a great pity, then, that the hon. Gentleman's party voted against the national insurance increases that are delivering the record levels of investment that are paying for improved facilities right across our country.

Peter Bone: I wonder whether there a mistake in the Government's amendment. It states that they are
	"reducing waiting times . . . to a maximum of six months".
	Is that an error? In Wellingborough only two weeks ago someone showed me that they were being asked to wait for 40 weeks for treatment, and two other people were being asked to wait 52 weeks. To me, that is more than six months.

Patricia Hewitt: Perhaps the hon. Gentleman will let me have details of that.
	By Christmas, we will have a maximum waiting time of six months for an operation—six months, compared with over 12 months, in many cases over 18 months and in some case 24 months under the Government whom the hon. Gentleman supported.
	The Gateway centre is giving its patients what we want for all patients: the best possible health and the best possible health care, with the best value for money. It is particularly relevant to the debate that both the hospital trust and the primary care trust are achieving financial balance.

Ian Austin: Given the Opposition spokesman's pathetic refusal to reply to the questions that he was asked earlier, can my right hon. Friend give her estimate of the effects of cutting NHS expenditure by £2 billion, which was the pledge in the patient's passport, and of the effects on the NHS of cutting the national insurance increase, which the Opposition parties voted against? Can she explain what effect that would have on NHS finances and services?

Patricia Hewitt: My hon. Friend makes an important point. [Interruption.] One estimate of the impact of taking out the £1 billion to £2 billion that the Opposition promised—or should I say threatened—at the general election to invest in their patient's passport would be a reduction by 9,000 consultants in the staff of the NHS, a massive reduction in care for NHS patients and a devastation of the NHS right across the country. [Interruption.]

Mr. Speaker: Order. The Chamber is getting very noisy indeed. The Secretary of State has come in good faith to speak to the House. We need some courtesy in the House.

Nigel Waterson: The right hon. Lady has been generous in giving way. Now that she has visited Newham, will she come 60 miles south to Eastbourne, where she will find a hospital trust in crisis, with the worst bed blocking in the entire NHS, people being turned away from out-patients and the trust being required to make £17 million of cuts in the current year?

Patricia Hewitt: In a moment, I shall discuss what is being done to deal with deficits, too many of which have built up over several years in health communities that have spent beyond their means, even though those means are significantly bigger than ever before.

Several hon. Members: rose—

Patricia Hewitt: I will not give way, because I intend to make progress.
	I want to be fair to the Opposition, who have recognised in their motion that there has been "unprecedented" investment in the NHS in the past eight years. Eight years ago, we inherited a wholly inadequate NHS budget of just £34 billion, which we doubled to nearly £70 billion in 2004–05. By the end of 2008, the NHS budget will be more than £92 billion, nearly treble what it was when we entered office, which reflects the strength of the economy under the prudent economic policies delivered by my right hon. Friend the Chancellor. Conservative Members may claim that they support that extra investment, but they voted against the means to pay for it.

Edward Balls: In my constituency, we have more than 1,000 extra doctors and nurses as a result of extra investment since 1997. [Interruption.]

Mr. Speaker: Order. I cannot hear the hon. Gentleman, and I want to hear what he has got to say.

Edward Balls: I am grateful for your support, Mr. Speaker. Will the Secretary of State reassure my constituents that this Government will never introduce a patient's passport? Does she think that there is any prospect of a cross-party agreement to rule out such a proposal at future elections?

Patricia Hewitt: My hon. Friend makes an interesting proposal. I can happily give him the reassurance that he seeks: we will never take money out of the NHS budget to subsidise private health care for the few, which is what the patient's passport involved. I am sure that Conservative Members will want to consider his proposal for a cross-party agreement before the next election.
	I look forward to Conservative Members answering this question, which the hon. Member for South Cambridgeshire has refused to answer: what is Conservative party policy on the patient's passport?

Mark Pritchard: rose—

Patricia Hewitt: Perhaps the hon. Gentleman will tell us.

Mark Pritchard: The Secretary of State has said that record investment has gone into the NHS, but my constituents are asking why the Shrewsbury and Telford Hospital NHS Trust has a £14 million deficit and why they face huge cuts to local hospital services despite paying record national insurance contributions. I was going to raise a point of order, but I will not. [Laughter.]

Patricia Hewitt: The hon. Gentleman showed great discretion at that point in his intervention.
	In a moment, I will discuss the underlying causes of the deficits in a relatively small minority of NHS organisations. [Interruption.]

Mr. Speaker: Order. I appeal again to the House for calm. We must allow the speech to develop, but it is far too noisy.

Patricia Hewitt: Thank you, Mr. Speaker.
	As we consider the challenges ahead, it is worth remembering—we remember this, and so do our constituents—the size of the task that we faced eight years ago, when, as Derek Wanless found in his recent report, the cumulative underfunding of the NHS amounted to a staggering £267 billion by 1998. That was the scale of the challenge that we faced eight years ago and, as we look back over those eight years, we can see how much better services are within the NHS. But there is still even more to do. The challenges that lie ahead include dealing with the financial deficits that exist in about a quarter of NHS organisations.
	At the end of the financial year 2004–05, the NHS as a whole had a deficit of around £250 million. That is less than half of 1 per cent. of total NHS resources. I would prefer—the whole House would prefer—to have no deficit at all, and in a moment I will explain how we are going to get rid of it. However, let me remind hon. Members of a fact that the hon. Member for South Cambridgeshire unaccountably failed to mention: in 1996–97, when the NHS annual budget was only £33 billion, the overall deficit was £460 million, which is almost 1.5 per cent. of a total budget that was, of course, far smaller.

Kali Mountford: My right hon. Friend mentioned value for money. In that context, I offer her my personal thanks for a very helpful intervention in advising primary care trusts about the prescription of Herceptin. My constituent, Karen Gibson, starts her treatment today. Such new drugs are expensive in the early years of their administration and set us a challenge in achieving value for money in terms of the investment that has to go into an individual's health care. Should we not consider health expenditure in the round, with the outcome that patients get better?

Patricia Hewitt: My hon. Friend is absolutely right. The measure of all this is in getting the best possible health for patients with the best possible value for money. Thanks to the wonders of medical science, many new drugs and therapies such as Herceptin are becoming available. Some of those are very expensive, and we must ensure through our reforms that we get the best possible value for money for every pound of taxpayers' money that we invest in the NHS.

Several hon. Members: rose—

Patricia Hewitt: I had better give way to the hon. Member for South Cambridgeshire, as he may wish to answer the question that he was posed earlier.

Andrew Lansley: In the expectation that the right hon. Lady would talk about the NHS deficit, I asked the National Audit Office for the figures on the cumulative deficit year by year. In 1997–98—the first year of the incoming Labour Government—the cumulative deficit was £26 million; in 2003–04, the last year for which figures are available, it was £276 million; and this year it is likely to be more than £520 million. Under this Government, the cumulative deficit has risen from £26 million to more than £500 million.

Patricia Hewitt: I suspect that the hon. Gentleman is muddling up the NHS deficit with the overall picture including the Department of Health. The figures that I have are very clear. In 1996–97—in other words, the last year of the hon. Gentleman's Administration—the overall NHS deficit was £460 million.

Several hon. Members: rose—

Patricia Hewitt: I am going to make some progress.
	In the last financial year, nearly three quarters of NHS organisations ended the year in balance or with a surplus. A minority of trusts had a deficit, half of which was in just 5 per cent. of NHS organisations—nine primary care trusts and 22 hospitals and mental health trusts.

Jim Cunningham: We are going to get a new hospital in Coventry. It is in the process of being constructed, and I recognise that there has been a lot of investment in it. However, I am concerned about University Hospitals Coventry and Warwickshire NHS Trust. I wrote to it five weeks ago asking it to justify a £7 million deficit, but still have not had a reply. There are press reports that 250 health workers are likely to lose their jobs, which could lead to a problem with cancer treatment. Can my right hon. Friend sort that out?

Patricia Hewitt: We are ensuring that every hospital or trust that experiences a deficit problem has proper support to sort out its finances and continue to improve its clinical services. I shall say a little more about that shortly. I shall certainly ensure that my hon. Friend receives a reply to his letter. I was glad that he mentioned the new hospital in Coventry—it is one of 138 hospitals that have been modernised, rebuilt or are under way.

Julian Lewis: The Secretary of State has spoken a great deal about value for money. Does she accept that community hospitals are great value for money? Does she agree that the deficit is not the result of the costs of community hospitals? Does she accept that when she boasts in the amendment about a programme of investment in community hospitals, it is hard to square that with the more than 90 community hospitals that are at risk of closure or serious service cuts? Will she confirm that the closure of community hospitals is not a matter of dogma for the Government?

Patricia Hewitt: As the hon. Gentleman knows, we are strongly in favour of modern community hospitals that bring more services into the community. I shall have more to say about that shortly. I want to develop the hon. Gentleman's first point about the reason for deficits.
	The hon. Member for South Cambridgeshire painted a lurid picture of a national health service in crisis. In reality, the vast majority of NHS hospitals and other organisations are cutting waiting times, improving services, treating more patients and living within their means. We expect that from every part of the NHS. The hon. Gentleman blames the deficit on managers and administrators. He claims that too many bureaucrats are wasting taxpayers' money.

Patrick McFadden: My right hon. Friend compared the deficit in 1997, when the Conservative party was in charge of the NHS, with that today. Would she also like to compare waiting times in the period when the Conservative party was in charge of the NHS with those of today? When the Conservative party was in charge, more than 30,000 people waited longer than 12 months for an operation. How many people today wait more than 12 months for an operation?

Patricia Hewitt: I am happy to say that nobody now waits more than 12 months. Waiting times have fallen as investment has risen.

Several hon. Members: rose—

Patricia Hewitt: I want to make progress.
	In trying to describe what he regards as the cause of the problem, the hon. Member for South Cambridgeshire called administrators a waste of taxpayers' money. I call them medical secretaries, records clerks, receptionists, caterers, launderers and cleaners—the hon. Gentleman claims that he is worried about MRSA. Those people also include health educators, medical librarians, financial managers and human resources specialists. I have examined all the groups that are included in the administration category. They also include IT technicians, maintenance staff and all other support staff.

Andrew Lansley: rose—

Patricia Hewitt: I shall give way to the hon. Gentleman because perhaps he would like to thank them.

Andrew Lansley: In the figures that I used—159,000 to 201,000—I expressly included managers and senior managers, who increased by 50 per cent., and staff employed in central functions and clerical and administrative support. I did not include cleaners or porters. If I had included all the support staff, the figure would have been 431,000 rising to 521,000. I left them out.

Patricia Hewitt: I have looked at what the hon. Gentleman put on the website and the press release that he issued this morning. I have examined the additional £1.2 billion, not £1.3 billion, that is spent on administrative staff. I assure him that all the medical secretaries, record keepers, health educators, IT technicians and financial managers, without whom our doctors, nurses, therapists and health care professionals simply cannot do their job, are counted among those administrative staff.

Stephen Hesford: The hon. Member for South Cambridgeshire (Mr. Lansley) claims that his figures refer to management. Has my right hon. Friend seen the figures from the NHS Confederation, which show, contrary to the erroneous assertion by the hon. Gentleman, that from 1999, the increase in management across the board has been only 2.8 per cent. of the work force, which is less than it was in 1999?

Patricia Hewitt: My hon. Friend is absolutely right and he anticipates a point that I wanted to make. In every year since 1996, administrative costs as a proportion of the total NHS budget have been falling. Exactly the same is true of management costs. They constituted 5 per cent. of the NHS budget under the Conservatives; they constitute just over 3.5 per cent. today under Labour. We can do even better than that, however. As part of the Gershon review, we have cut the number of staff employed in the Department of Health from more than 3,500 in 2001 to just over 2,000 by this year.
	On the investment that we are making in information technology, I was shown this morning the transformational effects of the electronic patient record that is being trialled at Newham hospital. That investment will slash the amount of time that clinicians and other staff have to spend chasing paper records. At Hinchingbrooke hospital, I saw the new electronic imaging and scanning system that has helped staff to cut the time taken to deliver a report to the consultant and the GP from anything up to 24 days to less than 24 hours. That is a massive saving in clinicians' and support staff's time.

Jim Cunningham: Earlier, my right hon. Friend said that she would get a reply to the letter that I sent to the University Hospitals Coventry and Warwickshire NHS Trust. Will she also look into why there is a £7 million deficit and a threat to 250 jobs there? I would appreciate it if she could do that for me.

Patricia Hewitt: As I was saying, the reason there are deficits in a minority of trusts is that, in some cases, there has been overspending, sometimes for several years, or poor financial management, or poor organisation of clinical services. We are taking the steps needed to reduce the overall deficit this year and to ensure that, at the end of the next financial year, the NHS will again be in balance.

Several hon. Members: rose—

Patricia Hewitt: No; I am going to make some progress.
	In the NHS in the past—this goes back decades—deficits in a minority of organisations were covered up. Money was moved around the system from a surplus organisation to a deficit organisation. The deficit trusts, those parts of the NHS that were overspending, were bailed out by other parts of the NHS that often had equal or greater health care needs. There was no incentive in the system that we inherited from the Conservatives to change or to improve. That is why we are changing the system.

Graham Brady: The Secretary of State mentioned cover-ups. Before the election, my local trust started to consult on the investment in and modernisation of Altrincham general hospital. Can she therefore explain why I have just heard that today, while this debate has been proceeding, the trust has adopted proposals to close Altrincham general hospital and massively to reduce services at Trafford general hospital? Do we not deserve some honesty from the Government? How can the public ever believe what the Government are saying when they are deceived in that way?

Patricia Hewitt: If a local trust has been overspending or running up a deficit, it will need to make decisions—in some cases, they will be difficult ones—in order to get itself back into balance. The hon. Gentleman talks about honesty, but we have still had no answer, honest or otherwise, on the question of patient passports.

Ann Winterton: Can the Secretary of State really sleep at night? She talks of deficits and the reasons for them, yet the Central Cheshire NHS primary care trust will not fund Herceptin, while every other neighbouring trust has done so—

Tom Harris: The Front Bench really misses you.

Ann Winterton: Would the hon. Gentleman like to   repeat that comment? I will give way to him. [Hon. Members: "Stand up."]

Madam Deputy Speaker: Order. The hon. Lady is herself intervening on a speech.

Tony Baldry: On a point of order, Madam Deputy Speaker. When I was a Parliamentary Private Secretary, it was a point of privilege. The behaviour of the Secretary of State's PPS this afternoon has been disgraceful.

Madam Deputy Speaker: That is not a point of order for the Chair, but clearly the remark is now on the record.

Patricia Hewitt: The hon. Member for Congleton (Ann Winterton) makes an important point about Herceptin. As she will know, I have already taken steps to ensure that testing facilities for HER2 will be available across the NHS in England, and for NICE to speed up dramatically its evaluation not only of Herceptin but of other drugs coming through the system. I have also made it clear that primary care trusts should not deny Herceptin, where it has been recommended by a clinician for an individual patient, purely on grounds of funding.
	In every strategic health authority, and for every deficit trust, a recovery plan is in place. Where the challenge is greatest—where the deficit is largest—the health authority and the trusts have been given more time to sort out the problem, together with transparent financial help from the NHS bank and other NHS organisations. For the organisations with the worst deficits, turnaround teams have gone in to help, not simply to consider the finances but, crucially, to make sure that the trust meets its waiting time and other targets and to help it to deliver the best possible patient care, together with the best possible value for money.
	This point is at the heart of the debate. Good patient care and sound financial management are not two things between which any part of the NHS can choose. Good patient care and sound financial management go hand in hand.

Several hon. Members: rose—

Madam Deputy Speaker: Order. I will give the Secretary of State time to decide which the hon. Member, if any, she will select.

Patricia Hewitt: I think that this is what is called an embarrassment of riches. I give way to the hon. Member for The Wrekin (Mark Pritchard).

Mark Pritchard: I am grateful to the Secretary of State for giving way. I am flattered, and I am glad that I parted my hair in the way that I did this morning—clearly, it works. On that point of financial mismanagement, how does she respond to the independent financial inquiry into the financial mismanagement and series of corporate failings of the Shrewsbury and Telford NHS Hospital Trust? Does she not feel a sense of responsibility, given that her office appointed the chairman, who has now resigned, the chief executive, who has resigned, and the deputy chief executive, who has gone? Does she not feel that she needs to make a statement to my constituents?

Patricia Hewitt: The hon. Gentleman makes the point that we are dealing with the matter. Where management has been inadequate, we are replacing management.

Several hon. Members: rose—

Patricia Hewitt: I want to try to make a little progress.
	I hope that Conservative Members can agree that we need both good patient care and sound financial management.

Graham Stuart: Will the Secretary of State give way?

Patricia Hewitt: No.
	Although the NHS is doing far better than it was eight years ago, it can do far better still.

Peter Bone: Will the Secretary of State give way?

Patricia Hewitt: No.
	Several hon. Members have made the point about extraordinary advances in medical techniques. As a result, patients do not need to stay in hospital for as long as they used to. Sometimes, they do not need to go to hospital at all. Indeed, as the admirable Mr. Fieldman told me in Newham this morning, a patient needing a gall bladder operation who in the past would have had to spend at least 10 days in hospital can now have the operation done during an overnight stay, or in some instances as a day case. The best of our NHS hospitals are among the best in the world and we should be proud of them. However, not all our hospitals are achieving the best—too many are not even achieving the average.

Several hon. Members: rose—

Patricia Hewitt: No, I will not give way. I want to make a point. [Interruption.] This is directly relevant to the point made by the hon. Member for South Cambridgeshire. He made great play of hospital beds, but completely failed to focus on outcomes or the impact of new medical techniques.
	One strategic health authority compared the lengths of hospital stay for patients with broken hips in the seven NHS hospitals in its area. Two kept patients in for about 20 days, below the NHS average of 25. The other five kept patients for longer than the average. In one case, the average length of stay was 38 days. Those five hospitals had the worst outcomes. The health authority calculated that if all the hospitals simply achieved the NHS average with all their patients, that one area alone would need 400 fewer acute beds.

Peter Bone: The Secretary of State mentioned speed and good patient care. Does she agree that the two may not go together? As she knows, last week I raised the case of a constituent who gave birth at 4.30 am and was thrown out of the hospital at 9 am because of a lack of beds. Is that what the Secretary of State means by speed and good patient care?

Patricia Hewitt: My point is that thanks to the extraordinary advances in medical techniques, anaesthetics and so on, it is now possible to do on a day-case basis what used to require in-patient care. It is possible to do in a few days what used to require a patient to stay in hospital for many days. It is possible to do outside hospitals what used to require in-patient treatment.
	It is true that, compared with the position when I had my two children some 20 years ago, the average length of stay for women having babies is now very short, and most women want to get home as quickly as possible. That may not apply to the case cited by the hon. Gentleman, but generally speaking it is true.

Several hon. Members: rose—

Patricia Hewitt: I have been generous in giving way. Now I want to give another example, involving patient appointments.
	Senior surgeons and leading GPs say that between 40 and 50 per cent. of out-patient appointments—on a conservative estimate—in acute hospitals could and should be dealt with by community hospitals, health centres or even large GP surgeries with equally good health outcomes, more convenience for patients and better value for money for taxpayers. That, of course, means fewer beds and fewer facilities in acute hospitals.
	Although there are outstanding examples of best practice throughout the NHS, there is not yet the value for money throughout the NHS that the taxpayers whom we have asked to pay higher contributions are absolutely entitled to expect.

Richard Younger-Ross: rose—

Patricia Hewitt: I will give way to the hon. Gentleman. His will be the first intervention from the Liberal Democrats—[Interruption.]

Richard Younger-Ross: Yes, one has been trying for a little time to catch the Secretary of State's eye. She spoke of good health care. Does she agree that recovery is better when patients are transferred from general to community hospitals? It is the community hospital beds that are at risk at the moment because of financial deficits in the primary care trusts. If we can keep those beds in place, in hospitals such as the Moretonhampstead in my constituency, we can free up bed space in the district general hospitals.

Patricia Hewitt: Is some cases, an intermediate care bed in a community hospital is a good way of bringing someone out of an acute hospital, but in other cases it is better to bring them straight home with the full support of the patient support team.

Ian Austin: On the matter of patient care, will my right hon. Friend confirm whether it is indeed the case, as my research has shown, that the number of MRI scans has increased under this Government from 473,000 in 1997–98 to 858,000 in 2003–04, and that the number of heart operations has increased from 39,000 to 65,000—[Interruption.] The more Conservative Members go on, the more statistics I can read out about—[Interruption.]

Julian Lewis: On a point of order, Madam Deputy Speaker. I realise that the Government are suffering from the fact that they are labouring on Benches that are heaving with all of about half a dozen of their own Back Benchers, but is it in order for a Government Back Bencher to intervene or ask a question on the basis of reading a script that was overtly handed to him by one of his own—[Interruption.]

Madam Deputy Speaker: Order. The House must come to order if I am to deal with a point of order—although it is not, in fact, a point of order for the Chair.

Patricia Hewitt: As my hon. Friend the Member for Normanton (Ed Balls) pointed out earlier in the debate, the Conservative party has just fought an election campaign on the basis of a patient's passport policy that would take between £1 billion and £2 billion out of the NHS to subsidise private health care for the few. That would not solve the deficits where they exist in the minority of trusts—it would add to them and devastate the care that the NHS is able to offer right across our country. That, of course, is absolutely in line with the Conservative policy of looking after the few and not the many. The investment that we are making—[Interruption.]

Several hon. Members: rose—

Patricia Hewitt: No, I will not give way.
	The investment that we are making in our national health service will continue—and so will the reforms and improvements. As we give patients more choice and a stronger voice, as we have more diverse providers but more freedom to innovate—as I saw at the Gateway centre this morning—and as we ensure that money follows patients with payment by results, we will give every hospital and every provider a real incentive to look at how they are working, to compare themselves with the best, to change their ways of operating, to move services from acute hospitals to community settings and to focus on prevention rather than simply cure. In other words, we will deliver the best possible health care with the best possible value for money.

Henry Bellingham: Will the Secretary of State give way—please?

Patricia Hewitt: No.
	We will invest more money than ever before in the NHS. Our constituents can see the improvements. Most NHS organisations are not only delivering improved, better and faster care, but living within their means. That is what we expect from every part of the national health service. I am proud—and every hon. Member on this side of the House can be proud—of the additional investment that we are making.

Several hon. Members: rose—

Madam Deputy Speaker: Order. It is for the Secretary of State to decide when or whether she gives way.

Patricia Hewitt: Madam Deputy Speaker, I am proud and we are proud of the more than 78,000 extra nurses and 27,000 extra doctors employed by the NHS, and the 500,000 more operations being carried out every year. With more patients treated and more lives saved than ever before, we will continue on our path of investment and reform. That stands in striking contrast to the policy of the Conservatives, so I commend our amendment and our programme to the House.

Sandra Gidley: I am pleased to debate this subject today, and I am delighted that the Conservatives have made it clear that they are committed to the provision of
	"comprehensive, high quality health services, based on need and not ability to pay".
	There has been some doubt about that in the past—a doubt that was echoed by Labour Members when they queried the Conservatives' reluctance to commit to funding the health service, and their voting against the £8 billion funding increase associated with the increase in national insurance levels. However, the most important task for us today is to examine Labour's record after eight years in government, and to consider why, despite record levels of investment, many local health services are lurching from crisis to crisis, like a drunk on a Saturday night who grabs at anything in an attempt to stay upright.
	I shall return to the question of the deficit shortly, but at this point I want to be fair and to acknowledge that some things have got better. When I was first elected in 2000, my postbag was full of letters from constituents who had been waiting years for hip replacements or hearing aids, or waiting months for heart operations classified as urgent. Such problems have been sorted out to an extent, but others are emerging in our local health services. I suspect that my experience is similar to that of many Members, in that today's issues for my constituents are the rationing of certain treatments and medicines, fear of MRSA, and the reorganisation of local health services. In an unprecedented development, NHS staff are writing letters to whistleblow on changes that they are particularly unhappy with. Such changes often mean a relocation of health services or a loss of hospital beds.

Mark Francois: Is the hon. Lady aware that in the run-up to the general election, the Government were pushing very heavily a brand new diagnostic and treatment centre at Fossett's Farm, in Southend, to relieve pressure on Southend hospital, but once the election was safely out of the way, they promptly cancelled it? Does she think that a shocking and awful thing to do? The people of Essex certainly do.

Sandra Gidley: I can understand why local people think that dishonest, and presumably there are other such examples from elsewhere, but I am not aware of any specific ones.

David Burrowes: Will the hon. Lady give way?

Sandra Gidley: I was struck by the number of Members who tried to intervene earlier to discuss the problems in their health economy, but I will not give way just yet as I want to develop my argument.
	The one question that is common to nearly all the letters that I receive from constituents, no matter what issue they are raising, is: where has all the money gone? The NHS Confederation recently produced a briefing—not for this debate, I hasten to add—to try to answer that very question. Its summary states:
	"Fifty per cent. of new investment has been spent recruiting new staff and paying higher salaries".
	Some 20 per cent. of the new investment was spent on employing additional staff, and 30 per cent. was spent on additional pay for existing staff. The confederation's view is that that has led to people being treated quicker and more effectively, but the opposite view has been espoused from some quarters that although this money is welcome, the staff pool merely expands to meet the available budget. One problem has been a failure to ensure that the right services receive the right money.
	Another major area of NHS spending is the drugs budget. In 2004–05, 686 million items were dispensed in England—an increase of 5.6 per cent. on the previous year. The drugs bill has risen by 46 per cent. since 2000 and now stands at some £8 billion. I do not share the view, espoused today in The Daily Telegraph, that that is a scandalous waste of money. Better prescribing has in many cases led to better outcomes. The prescribing of statins, for example, the current annual cost of which is £70 million, has the benefit of saving an estimated 9,000 lives a year. I am sure that those people are very grateful for that investment. Another claim on NHS resources has not been mentioned. The cost of inflation-proofing pensions has been transferred from the Treasury to the Department of Health—a classic case of the Treasury giving with one hand and taking away with the other.
	It is also worth mentioning the NHS IT project, a huge investment amounting to more than £6.2 billion over 10 years. Unfortunately, the process seems to be dragging on somewhat, so far with little apparent benefit for patients. For example, the choose and book system for hospital appointments was due this December, but will be at least a year late. Predictably, Richard Granger, the man in charge of the scheme, has said that that is not his fault and claims that responsibility for the late delivery lies with the policy people at the Department of Health. If the Secretary of State is able to elaborate on the problems at the Department, I am sure that we would all be very interested.
	To date, only 20,000 appointments have been booked. To put that in proportion, I can tell the House that about 9.5 million appointments are made every year, and that the target was to have 250,000 trial appointments booked by last December.
	The NHS faces other significant cost pressures, such as those incurred by clinical negligence cases and the implementation of NICE guidance. However, the NHS Confederation is most interesting when it comes to the subject of why the service needed the extra money in the first place. It notes that Wanless analysed the state of the deficit under the previous Government, especially as a result of the tight financial settlements of the 1980s and 1990s, and then states that that cumulative deficit
	"goes a long way to explaining the shortage of many types of staff, the poor condition of many buildings and the low level of investment in equipment."
	I stress that the confederation is talking there not about the present situation, but about one that pertained some years ago. It also said:
	"A culture developed in which NHS organisations were expected to report that they had 'broken even' without any enquiry into whether the methods used were sustainable."
	That led to cuts in cleaning and catering budgets, and the confederation added that
	"many key developments were put on hold, delayed or scaled back."
	It reported that that affected the health service's approach to the prescribing of new drugs, as well as to matters such as buildings maintenance, staff shortages, staff training and new equipment.
	At one stage, there was a freeze on the appointment of new consultants. In that, we might have come full circle, as the BMA has received reports from various quarters of a proposed freeze on consultant recruitment, and says that there is a threat of redundancies among consultants. The Royal College of Nursing has tracked the accelerating effects of the deficits since January, and only last week expressed concerns about the possibility of widespread nursing redundancies. Beverly Malone, RCN general secretary, said:
	"We are putting a spotlight on this issue now before it is too late. Valuable, highly experienced frontline staff could be lost and we simply cannot afford to let this happen. It will hit patients services and put even more pressure on the nurses that are left. Nurses have delivered huge improvements in NHS services and they have led the way in modernising the NHS. These job losses are a slap in the face to them and suggest their past, present and future contributions are of little value."
	I do not think that any hon. Member would say that the contribution made by nurses was of little value, but it is a matter for concern that the RCN should feel it necessary to put that on the public record.
	That is the background, but I want to return to the situation that exists today. Overall, the NHS has just about squeezed in on budget, but about one trust in six is in deficit. The problem is getting worse, and the National Audit Office has said that 12 SHAs ended the financial year 2004–05 in deficit, compared with seven the previous year.
	Earlier, the Secretary of State said that financial managers responsible for a lack of prudence had been moved out of the way. I pay tribute to the new chief executive of the Hampshire and Isle of Wight health authority, Sir Ian Carruthers. He has a very good strategic overview, wants to keep services, and seems to be the only person who understands how all the trusts meld together. However, it is somewhat disappointing that his failed predecessor should have been given a plum job in Whitehall. It might be an interesting exercise to see what happens to failed SHA chief executives, and find out whether all of them have been given similarly cushy numbers.

Philip Hollobone: Is the hon. Lady aware that pressures on local health services are particularly acute in areas with rapidly growing populations? Is she aware that in the Secretary of State'slocal health authority—the Leicestershire, Northamptonshire and Rutland strategic health authority—the PCTs are underfunded by £88 million below the national capitation fund? It is the worst funded strategic health authority in the country.

Sandra Gidley: I was always under the impression that Hampshire was the worst funded health authority. It is certainly the case that the funding formula is not fair and does not create a fair distribution. While there is a case for giving more funding to areas with higher health inequalities, such as the north-east, the spread of funding causes particular pressures on those at the bottom end of the funding scale. A slight narrowing of the scale would make a great difference, especially to authorities in the south-east which are more likely to be in deficit. It is interesting to look at a map of the strategic health authorities in deficit, because it shows that the problem is weighted towards the south-east.

Richard Younger-Ross: In the south-west, the number of PCTs in deficit is greater than one in six, although my own PCT team has done exceedingly well. One of the reasons cited by the strategic health authority, which has lobbied us on the issue on many occasions, is that the funding does not take account of sparsity or the coastline effect, which make the costs higher than average.

Sandra Gidley: We could probably have a separate debate on the special factors that could be taken into account in the funding formula, but I take my hon. Friend's point.
	Twelve NHS trusts reported a deficit of more than £5 million in 2003–04. The King's Fund has pointed out that NHS productivity has fallen, according to the official measure, but it also acknowledges that that is not necessarily a measure of quality. How should we measure quality in the NHS? In recent years, we had the star ratings—now largely discredited—and the trusts learnt to play the game. Resources were put into areas that had targets associated with star ratings. Not only did that sometimes cause trusts to spend money that they could ill afford, but health services not associated with the targets became easy options for savings.
	A particular example of that tendency is specialist services, such as renal and dialysis services, which are especially vulnerable. They are expensive and affect relatively few patients, and the same provider often services several PCTs. They are easy targets but patients diagnosed with one of the specialist diseases—there are 34, but I shall not list them all—should not suffer as a result of the historical financial health of local NHS organisations. When payment by results is introduced, some of those existing inequalities could be exacerbated.
	It would be bad enough if that were the whole story. However, the British Medical Association has pointed out that cash shortages in the NHS contrast dramatically with the generous terms negotiated with some private sector providers—as Conservative Members have pointed out. The BMA makes the point that it is cause for even greater concern when the contracts agreed with such companies allow payments to continue, despite significant underperformance. Examples include the orthopaedic contracts in south Yorkshire and Trent and some MRI and eye contracts. It would be useful if the Secretary of State could explain what sanctions are in place for when private providers do not deliver the services for which they are contracted.
	In many cases, the cuts have taken place with little or no clinical engagement and—unfortunately—even less public engagement. In September, the BMA conducted a survey of trusts that revealed that one in three planned to reduce services. Intended reductions included bed closures, staff redundancies and a freeze on recruitment, reduced elective services, ward closures, cuts in training and a reduction in patient transport services. Three quarters of respondents reported that their trust faced a financial shortfall in the current financial year and more than a third reported that funding agreements with PCTs had been changed at short notice.
	The Government cannot have it all ways. Financial instability is an inevitable consequence of reintroducing the internal market. In any market, there are winners and losers and rushed reforms tend to exacerbate existing inequalities. Does the Secretary of State think it wise to introduce a system that sets hospitals against each other, rather than encouraging them to work as partners in providing the best possible overall service for patients? The market mechanism depends on successful trusts gaining patients while others lose out.
	Some people have asked what will happen to spreading best practice. If one trust is doing particularly well and attracting many patients, there is not much incentive for it to spread the secret of its success. The hospital losers will face bigger deficits; they will have to make more cuts as a consequence and the downward spiral will increase. The real losers will be the patients, although that might not be the case if local accountability was improved.
	At present, the accountability of senior officers in primary care trusts or acute hospital trusts is to politicians at Whitehall. The focus is very much on delivering the targets that the Government want. That may be fine but sometimes it does not take into account local needs and local decision making. Perhaps we should move towards a system with more accountability to local people.
	It seems slightly ironic that the Government are engaging in a large-scale listening-to-Britain exercise and are making knee-jerk announcement after knee-jerk announcement, yet the public feel increasingly that consultations at local level are tokenistic, decisions have already been made and local health managers are not listening.

Mark Hoban: I am grateful to the hon. Lady for raising the issue of public consultation. Does she share my disappointment that mothers in my constituency were told only 14 days before it took place of the closure of the Blackbrook birthing centre? That closure was made as a result of financial and staffing problems in Hampshire PCTs and hospital trusts.

Sandra Gidley: I share the hon. Gentleman's disappointment and shall return to that point briefly later in my speech.
	Nowhere is the problem more apparent than in the many closures of community hospital beds throughout the country—90 examples have been mentioned. In many cases, local communities raised significant amounts of private money to invest in their community hospital so there is a growing sense of anger.

Mark Simmonds: The hon. Lady is making a pertinent point. In my constituency, it is proposed to close one ward of the Skegness and district general hospital, which is 50 per cent. of the hospital. East Lindsey district council, the local authority, offered the primary care trust £90,000 to allow the ward to reopen immediately, but I understand that the Government blocked that offer. Does the hon. Lady agree that that is an absolute disgrace?

Sandra Gidley: I do not know the details, but it is clearly disappointing that blocks are put in the way when someone has come up with a creative solution to a problem. I have been working with the hon. Members for New Forest, West (Mr. Swayne) and for New Forest, East (Dr. Lewis) on a similar problem, and the hon. Member for New Forest, East came up with a similar idea. It has not been developed, although not for the same reasons. I hate to think that we could have developed our project to an advanced stage only for it to be scuppered at the last moment.
	In many communities, there is a growing sense of anger that health organisations are trying to take away something that belongs to, and is very much part of, the community. In south-west Hampshire, some of us have been working together against the proposed closure of community beds in hospitals in the New Forest and Romsey. We work across the political divide, which has gone down well with the public who regard it as unusual for politicians of different parties to work together. We tried to present a united front to the local PCT alliance to persuade it to rethink the ill-thought-through proposals to close hospital beds.
	One option—described by someone as the nuclear option—was to close all community hospital beds in the area. That proposal completely ignored a bed survey that showed a great need for patients to move out of the acute hospital trust and into the cheaper, and some would say friendlier and more homely, community hospital beds. So huge amounts of money are being wasted in the local health economy by keeping people in acute hospitals inappropriately. The scandal is that the managers have not got their heads around moving people more effectively through the system and that the knee-jerk reaction has been to cut the number of beds at one end of the scale.

Graham Stuart: Does the hon. Lady agree that the problem is not just that closures in community hospitals will cause bed blocking, but that overstretched ambulance services—many of which are already struggling to reach their targets, not least in rural areas—will be further inconvenienced and schools, such as the Hornsea school in my constituency, will use ambulances for minor injuries, taking those services away from people who need them more?

Sandra Gidley: Ambulance services have frequently been a target for underfunding by other trusts. Again, a lot of this boils down to having good overall strategic management that can ensure that ambulance trusts are funded. As I mentioned earlier, the BMA survey showed that the possible reductions in patient transport can cause great problems for many patients.
	As well as the problems posed to patients by closing community hospitals, what has not been pointed out is the effect on social care budgets. If patients are treated at home, instead of in community hospitals, they become liable for all their personal care needs. That involves means-testing and patients paying money that they probably can ill afford to pay, but they are often unable to think about that when they are trying to recover from an illness. The burden on social services departments has not been mentioned today. We could have a parallel discussion of the problem of moving patient treatment from health to social services and the impact that that has had on social services budgets, many of which are over-spent.

Anne Milton: Does the hon. Lady agree that we need to discuss the serious issue of the cost shifting that will go on as a result of the closure of community beds? Indeed, a lot of local councils are already very concerned about their budgets for next year. One way to wipe out an NHS deficit is simply to dump it on local councils.

Sandra Gidley: I agree with much of what the hon. Lady says. The big problem is that local health trusts do not talk to social services departments when such changes are made. That causes huge problems. One Liberal Democrat policy at the last election was to develop a much closer melding of health and social care budgets, thus helping with some of those problems. In the proposed reorganisation in London, PCTs are starting to work with local authorities, but it is disappointing that the Government seem to want to break down the good working relationships that already exist.

Jane Kennedy: The hon. Lady might like to talk to her colleagues who run Liverpool city council, where relatives of the users of local authority social day-care provision, which is being closed down right across the city, have appealed to me to see whether we could find a way for the PCT to take responsibility for social services from the local authority. That is not exactly the best example of a local authority working in the interests of people in need of social care.

Sandra Gidley: The Minister's point reinforces my assertion that such perverse decisions would not need to be made if the budgets were combined.
	The Government claim that patient choice is all important. The Liberal Democrats believe that choice should not be artificial, such as that offered by the delayed choose and book scheme. Choice should involve a variety of provision available to all. That is particularly so with maternity services. A woman should have the right to choose between a home birth, a birth in a midwife-led unit or to be under the supervision of a consultant.
	On Monday, the National Childbirth Trust called on the Government to take urgent action to protect the future of birth centres in the UK and cited examples of recent service cuts, one of which has been mentioned by the hon. Member for Fareham (Mr. Hoban). Other places affected include my area of Romsey, and Petersfield, Southport, Malmesbury and Wakefield. The trust points out that because of staffing issues and financial constraints, a full range of maternity services is available to only a minority of women in the UK.
	The Secretary of State will be aware of the Labour manifesto pledge:
	"By 2009 all women will have choice about where and how they have their baby and what pain relief to use".
	Government policy emphasises the importance of choice by stating:
	"The range of ante-natal, birth and post-birth services available locally constitutes real choice for women"
	and
	"Local options for midwife-led care will include midwife . . . units . . . in the community".
	I could wax lyrical about the benefits of midwife-led units, but I will restrict my comments to asking the Secretary of State to investigate the problem and come to the House to inform us what action the Government are taking to reverse the situation.

Kali Mountford: Did the hon. Lady read, as I did, the report by the health service commissioner published earlier this year about the need to make maternity services more locally based? Is she aware that NICE is reviewing midwife-led services to ensure that there are also safe outcomes? Should we not be ensuring that there is a proper balance between locally based services and ensuring that the outcomes are safe for both mother and child?

Sandra Gidley: I am not quite sure what point the hon. Lady is making. It is quite insulting to midwives who work in midwife-led units to suggest that those units are somehow more dangerous to women. Many women have perfectly safe births in such units. Midwives are the experts on birth, so I find the hon. Lady's comments rather strange. However, of course, we must wait for the NICE review.
	I am alarmed that some of the cuts that are apparently the easiest to make are those to aspects of the public health and preventive health agendas. I was interested by the Secretary of State's closing remarks because although she said that public health was a Government aim, that does not seem to be shown by the situation on the ground.
	I shall cite a local example. Owing to the deficits, a local hospital wanted to cut cardiac rehabilitation classes, which offered people post-operative exercise and re-education about their lifestyle. They were a good aspect of the preventive health agenda. There was public uproar and the decision was reversed.
	There is excitement in my profession of pharmacy about the new pharmacy contract, but that is tempered by the fact that many primary care trusts do not have the money to develop new services, especially if there is an underlying deficit.

Justine Greening: The hon. Lady makes a valid point. In the London borough of Wandsworth, our primary care trust has a substantial deficit of £8 million. In fact, that deficit is one of the things that is stopping its proposal to reopen Putney hospital, which was shut under this Government. However, £300,000 a year is being spent on keeping the site secure while we decide what will happen, and that valuable asset is not being used. Does she agree that that is a disgrace and a waste of valuable taxpayers' money?

Sandra Gidley: Sadly, hon. Members have cited many examples of taxpayers' money being wasted. I have sympathy with the residents of Putney.
	Surely it is short-sighted not to think about funding the new pharmacy contract when approximately a third of all hospital admissions are drug related and many people live with long-term conditions that could be managed more effectively with a little help. Pharmacies can deliver obesity-management and smoking-cessation services, so a golden opportunity is being squandered when such services are not encouraged and possible long-term savings are not being achieved. Other Cinderella services include mental health services and those involving mainly older people, such as stroke services.
	Liberal Democrat Members will support the Conservative motion because it must worry us all that unprecedented amounts of investment have not been accompanied by improved patient outcomes across the board, and that the Government are spectacularly failing to monitor, control or improve the situation.

Several hon. Members: rose—

Madam Deputy Speaker: Order. May I remind all hon. Members that Mr. Speaker has imposed an eight-minute limit on all Back-Bench speeches?

Laura Moffatt: I decided to apply to take part in this very important debate because, first, as a former nurse, I worked in the national health service for more than 25 years, and, secondly, I am one of the Members of Parliament whose acute trust has the highest deficit in the country. I want to contribute to trying to understand deficits, how they come about and how we in this House have a responsibility to explain properly what is happening to the new health service of today. Sitting in this Chamber, laughing, joking and joshing is not the way to tackle very serious matters.

Crispin Blunt: Will the hon. Lady give way?

Laura Moffatt: Not at this point.
	As the Secretary of State clearly outlined, we are right to be sceptical about why this debate was called, although I believe that it is perfectly right to look at deficits in the NHS and for Members to consider them seriously. However, it galls me a little to hear some of the comments from the debate, because as a nurse working in a trust, I was asked to forgo half of my pay rise because there was no money to pay staff. Strangely, that was in 1996, when I believe we had a Conservative Government.

Crispin Blunt: Will the hon. Lady give way?

Graham Stuart: Will the hon. Lady give way?

Laura Moffatt: No, I will not give way at the moment. We need to put the debate into context, and if we do not do so we shall not have an honest and honourable debate.
	We know how much funding has increased. Indeed, the extra cash that has gone to the NHS is astounding—it is something that we dreamed of. Before 1997, we did not believe that that could become a reality. We therefore have to consider what can go wrong against the background of that extra funding to the NHS, and understand why some trusts get into difficulties.
	I am afraid that for Surrey and Sussex Healthcare NHS Trust the pattern of decline was set many years ago when Crawley hospital was not invested in, when its priorities were not foreseen, when it accumulated an enormous amount of necessary repair work and when issues connected with the quality of service were not tackled. I know, because I was a night nurse who more often than not worked alone without the support of senior doctors. So, on the day after the momentous election in 1997, I knew that we would face difficulties, because there was no way that a Labour Government would allow the quality issues in the NHS to be ignored. It would have been easier—

Graham Stuart: Will the hon. Lady give way? Go on, give way.

Laura Moffatt: In a moment.
	It would have been easier for us to jog along and not tackle many of the issues. Our local residents would have thought that everything was fine in the NHS, that there were no problems and that there was no need to worry about senior staff or accreditation and the fact that the royal colleges were going to withdraw the support of junior doctors in the trust—but of course we had to worry.

Crispin Blunt: While the hon. Lady is dealing with the issue of deficits I hope that she will not overlook informing the House of her own contribution to creating a deficit at Surrey and Sussex trust by her intervention in 2001 to stop the reorganisation of services between her hospital and East Surrey hospital, which cost more than £10 million and continues to cost that today.

Laura Moffatt: I am very grateful to the hon. Gentleman for raising that issue. I do not know whether he is aware of just what a fantastic contribution he made to ensuring that my constituents knew that I was fighting on their behalf to keep our hospital open. I publicly thank him for his work, because I could not have paid for the publicity that he gave me. I do not think that any Member could be criticised for ensuring that their hospital survives.
	As I said, there was a lack of investment in Crawley hospital. Without doubt, it would be closed by now if the Labour Government had not ensured that money was available to keep it going. The agenda was clear. Without a shadow of a doubt, Crawley was ready for closure, because no investment had been made in it. I am therefore deeply proud of my contribution to efforts to ensure that it remained open.
	The issue of deficits overshadows much good work. My main complaint is that it is difficult to talk about anything other than deficits in any forum, even when £19.2 million of desperately needed capital investment has been made in Crawley hospital. That money has been used to provide a dialysis unit and to upgrade the walk-in centre to an urgent treatment centre that will see people 24 hours a day. Some 85 per cent. of people who came through the door of the walk-in centre will still be entitled to do so to receive emergency care. This debate appears to suggest that everything is wrong, but even in the trust with the biggest deficit in the country significant improvements are under way. Staff are delivering services that I did not even think possible. The trust can offer cardiac catheterisation. People used to go to London to have that done, but they no longer need to do so. A chronic disease management centre is under construction at Crawley so that people can receive walk-in care and will not have to spend weeks in hospital. GPs in my area can now refer dermatology patients for treatment the same week. They used to wait 22 weeks for such treatment.

Graham Stuart: The hon. Lady said that the Labour Government would not ignore quality issues. Does she think that the doubling of deaths from hospital-acquired infection shows a Government committed to quality?

Laura Moffatt: I am worried about the way in which the hon. Gentleman phrased that question. I worked in an isolation unit, where I cared endlessly for people with hospital-acquired infection. We did not even count the number of people trooping through my ward. A day did not go by without another ward ringing to inform us of another patient who had to be isolated because of hospital-acquired infection. We therefore need to be careful about the way in which we articulate the problem. The way in which we are tackling it now bears no relation to the way in which we did so before 1997. At that time, there was no commitment to address quality issues, and we did not prescribe the drugs that are used today. Soon after the 1997 election, surgeons and medics in my area, particularly those who were dealing with cancer patients, rang us every other day begging us to release drugs for treatment. That no longer happens. I accept that there is a big debate about Herceptin, but, quietly and gently, people are now receiving the services that they need. Locally, people might be upset if services change and there is no longer a hospital on their doorstep that can offer them all the services they need, but when they do receive hospital treatment they know that they will receive a first-class service.

Grant Shapps: I accept that the hon. Lady is speaking with a great deal of sincerity, given her nursing background. However, is she not in the least concerned that things are going off the rails? We have heard many stories about trusts in deep deficit—indeed, a deficit of £1 billion may be run up next year—so is she not embarrassed about her Government's performance?

Laura Moffatt: No, I certainly am not.
	We need to get deficits under control. We have a fantastic campaign group in Crawley that is desperate to have a new hospital. We cannot offer that unless management can control the budget, which will enable us to move forward and offer even more services to more people, thus ensuring that the Labour Government do what people expect them to do—deliver a first-class NHS.

Nigel Waterson: I am delighted to be able to take part in this timely debate. I called a debate on 6 April about the problems at my hospitals trust. It was the last Westminster Hall debate of the previous Parliament. The position then was extremely grave. The trust had issued a press release referring to extreme pressure on the hospital, 97 per cent. bed occupancy over a period of six weeks and 158 operations cancelled, and it was proposing to close accident and emergency for periods because of the severe pressures. The then chief executive said:
	"When levels of bed occupancy reach into the upper 90s risks of clinical errors become unacceptably high."
	I had a meeting at the time with the Minister of State, the hon. Member for Doncaster, Central (Ms Winterton), which she will remember, and she agreed to put a recovery and support unit from the Department into the local NHS. In short, we had some serious problems.
	What has changed since April? We had a general election campaign and suddenly, miraculously, some funds were found to ease some of the bed-blocking problems that we had at the time. We already had the highest level of bed blocking in the entire NHS. We have seen nothing of the recovery and support unit. It may have intervened, but as far as I am aware, it has not been to my local hospital. Extra funding has been put in by the county council. East Sussex county council has again had one of the lowest, if not the lowest, settlements of any county across the country, but in the past four years it has managed to increase spending on older people's services by 35 per cent., despite the fact that over that four-year period its central Government grant has increased by only 1 per cent. if one strips out the money passported to education.
	What has the hospital done? It has opened a new, allegedly temporary ward, the Polegate ward, in the car park. It has tried many different ways of reducing the level of bed blocking in Eastbourne and Hastings, yet delayed transfers of care remain stubbornly high. Recently, they nearly reached 100 beds—that is, 10 per cent. of all the beds across the whole hospitals trust. That has led to cancelled operations. In a six-month period, 472 operations were cancelled at the last minute. This year the trust is expected to make cuts of £17 million.
	In August the then acting chief executive sent a letter to all consultants in the hospitals dealing with the overspending, making it clear that reducing the deficit and getting back into balance was a priority alongside MRSA reduction, cancer waits, emergency access, waiting times and so on, and pointing out that tough budget decisions were needed, with no issue off limits for debate. The letter mentioned also
	"the burden of decisions which have major safety or 'political' implications."
	One of the problems with the bed blocking has been the difficult budget for social care in the county of East Sussex. We have the highest proportion of over-85-year-olds in the entire country, which has put an immense burden on social and health care. The county council is spending above average per head on the problem, yet contrary to popular belief—it certainly seemed to be the belief of the Minister who answered my debate in April, now the Transport Minister—average earnings in East Sussex are some £5,000 less than the average for England.
	Since April, the problems have got worse, not better. Staff, patients and their families have experienced intense pressure, a high level of operations have been cancelled and the bed blocking is the worst in the entire NHS system.
	In the meantime, we have lost our chief executive, who left in slightly mysterious circumstances, and I have been unable to obtain details of the severance package paid to her. A new chief executive was parachuted into the trust without the post being advertised, without competitive interviews and without any of the other provisions that are normally observed in the public sector. There has been a culture of secrecy at the local trust, although Ministers have stated in written answers that they were not involved. I suspect that the strategic health authority was the real driver behind that culture, but I am yet to accept that there are no ministerial fingerprints. Many of my constituents think that if several hundred thousand pounds—this is a rumour, but rumours can be countered by publishing the details—have been taken out of patient care for a severance package, the matter should be put in the public domain.
	We have a new problem, as well as a new chief executive, whom I wish well given the problems that she faces. Only a few days ago on 9 November, the hospital announced unilaterally that it will turn away patients from out-patients, because it has reached the level agreed in the contract with the local primary care trusts, but the PCTs dispute that point and take the view that it is still under contract. In fairness to the PCTs, they have stepped forward to try to ensure that every patient is seen within the 13-week period, even if patients have to be referred to private providers. I hope that that is what happens, but I do not want to see an additional burden being transferred unilaterally to my local PCTs, not least because they are also in deficit. When I asked the chairman of my local PCT at its annual general meeting in the summer whether the PCT would prioritise patient care or eliminate the deficit, she made it clear that the PCT would put patient care over eliminating the deficit.
	I have tabled an early-day motion asking the Government urgently to review funding in East Sussex for social and health care, particularly having regard to the high proportion of elderly people to which have I already referred. I have not yet received an answer to this vital question: will eliminating financial deficits or the clinical needs of patients take priority under this Government?

Stephen Hesford: The hon. Member for Eastbourne (Mr. Waterson) has said that the debate is timely, and I think that he is right.
	Conservative Members have mentioned the word, "embarrassment", but the two go hand in hand. One of the reasons why the hon. Member for South Cambridgeshire (Mr. Lansley) was unable to answer questions about the patient's passport is that one Conservative party leadership contender likes them, while the other says that they are old hat. Until Conservative Members work out that conundrum, it is embarrassing for them to call a debate such as this. My right hon. Friend the Secretary of State has said that she is proud of what the Government have done for the NHS, and I am proud of how the NHS delivers in my constituency—if I have time, I will raise some relevant examples.
	Conservative Members should also be embarrassed by their motion. I have already questioned the sum of £600 million, which is a gross exaggeration, so I am glad that the hon. Member for South Cambridgeshire is back in his place. It is an exaggeration, too, to speak of £1 billion. When my right hon. Friend the Secretary of State talked about administration costs, the hon. Gentleman tried to focus on management costs. According to the NHS Confederation, there are fewer people in management, as a percentage of the work force, than in 1999.
	My hon. Friend the Member for Crawley (Laura Moffatt) indicated how deficits occur. Conservative Members must understand that we inherited an appalling situation. In many cases, any deficits that occur have been rolled over from year to year as a result of inherited deficits from the Conservatives' time in government. My right hon. Friend the Secretary of State was right to point out that we inherited what Wanless described as a £3 billion cumulative under-resourcing of the NHS. We have been trying to put that right, as well as increasing investment.
	I want to talk about the situation in my constituency. It is often valuable advice for hon. Members to speak about that which they know, and I know the situation in Wirral very well, having for eight years met people from all parts of the NHS every three months in order to understand their story as it has unfolded. It can be painful to shift resources from the acute sector to the community sector to create a primary care-led, patient-led NHS. That can lead to budgetary difficulties. To deal with that, the Government will in due course publish a White Paper on care out of hospital.
	One of the reasons for making primary care trusts focus more on commissioning is to ensure that there is patient choice and direct management control. That means that there is no power struggle between the PCT and the acute trust, as has sometimes happened, and resources can be directed towards an NHS that is properly redesigned for the future. My local acute trust has taken the necessary action to design a service that leads to recurrent savings in resources. As a result, its deficit has disappeared. I commend that approach to Members on both sides of the House and suggest that they should have a conversation along those lines with their own acute trust management.
	When Labour came to power, the budget for my acute hospital was just over £100 million; now, it is nearly £300 million. It is one of the largest non-teaching hospitals in the country. It was an 800-bed hospital; now, it has nearly 1,000 beds. I do not recognise Conservative Members' accusations of bed cutting. Indeed, I had the honour of opening a 12-bed high-dependency unit costing £1.2 million just before the 2001 election.
	If Conservative Members want a serious debate, I thoroughly recommend that they first have a conversation in their own patch to see whether their NHS management is doing all that they could with the money that we have provided, which is more than enough.

Tony Baldry: The House heard an incredibly complacent speech by the Secretary of State. She has fallen into the trap that all Governments fall into in their dying days—that of having her officials only take her to see Government flagship projects. Half her speech was taken up with trumpeting flagship projects, and she did not wish to hear about any of the problems that are being experienced in parts of the country that are suffering from deficits.
	I issue to the Secretary of State the same invitation that I have already issued to her fellow-Ministers—the Minister of State, the hon. Member for Doncaster, Central (Ms Winterton) and the Under-Secretary, the hon. Member for Birmingham, Hodge Hill (Mr. Byrne)—in debates in Westminster Hall: please come to Oxfordshire to see the other side of the story. The health economy in Oxfordshire is in freefall. The strategic health authority tells us that in the next six months the Oxfordshire health economy has to save £35 million.
	Those cuts are the responsibility of Ministers. Under the present Government funding system, Oxfordshire receives only 85 per cent. of the national average for NHS funding. Ministers say that that is because Oxfordshire is wealthy compared with other areas, but it is exactly that comparative wealth that presents the NHS in Oxfordshire with some of its most difficult problems. Housing costs are high, as are nursing costs and agency costs.
	What does that mean for our local NHS? The Government's funding plan has already resulted in the proposed closure of the gynaecological ward at Horton hospital in Banbury, and the Oxford Radcliffe Hospitals NHS Trust is considering closing wards at the John Radcliffe hospital and the in-patient pain relief unit at the Churchill hospital. Wards are being closed, beds are being lost, and community hospitals are either not being built or under constant threat of closure.
	The Government's amendment has the audacity to claim that they are investing £100 million in a community hospitals programme. Way back in 1997, the right hon. Member for Darlington (Mr. Milburn) stood at the Dispatch Box and promised the people of Bicester a new and enlarged community hospital. We are still waiting for it. In the other place, Lord Warner cannot even tell us whether community hospitals will have beds. If the Government cannot recognise that a community hospital must have beds, God help us all.
	The Oxfordshire health economy has to try to save £35 million this year, £25 million of which is to come from the Oxford Radcliffe Hospitals NHS Trust. That can happen only under slash-and-burn cuts. Yet when Ministers are asked about that, they do not take responsibility, but pass it on to the strategic health authority.

Jeremy Hunt: Is my hon. Friend aware that, under this Government's funding formula weightings, the priority given to social deprivation is three times greater than that given to the proportion of elderly people in an area or to the costs of health care delivery? Does he agree that the people who suffer when that happens are not rich people living in rich areas but poor, elderly and vulnerable people who happen to live in areas that have Conservative Members?

Tony Baldry: The weak and the vulnerable will suffer as a consequence of the Government's complacency about what is happening in the NHS. More than that, the Government wash their hands and claim that strategic health authorities make the decisions. They say that SHAs can set out recovery plans, but I wrote some three weeks ago to the chief executive of the Thames Valley health authority to stress that there was no way in which the Oxford Radcliffe Hospitals NHS Trust could save £25 million between now and the end of the financial year. I continue to await a reply. I suspect that the reason is that, yet again, we are undergoing an NHS reorganisation, with all the PCTs in Oxfordshire becoming one.
	There is an added twist in Oxfordshire. Clearly, some wise guy in No. 10 thought that it would be fun to consider putting out the management of the Oxfordshire PCT to the private sector. Ministers cannot even work out whether they want to accept the responsibility for that. The Guardian on Saturday reported that Ministers had given an indication that the PCT in Oxfordshire could not go out to private management. Yet the previous day, the Minister of State said in a parliamentary answer:
	"No decision has yet been taken on the possibility of any strategic health authority (SHA) tendering for the private sector provision of management services for future primary care trusts (PCTs)."—[Official Report, 11 November 2005; Vol. 439, c. 828W.]
	Why on earth does not the Minister simply say, "PCTs are not going to be allowed to do this"?
	UnitedHealth, whose international director used to be an adviser at No. 10, clearly believed that the trust would be allowed to go out to private management. He wrote to me on 11 November, only last week. The letter stated:
	"The board of the SHA has approved the outsourcing."
	It is interesting that the international director is clearly privy to information that is denied the Royal College of Nursing and Unison. When those organisations had the temerity to ask under the Freedom of Information Act 2000—that is their only hope of discovering anything from the Government—they are effectively told to shut up because any discussions between the SHA, UnitedHealth and other providers are subject to commercial confidentiality. That is what will happen with outsourcing resources from the NHS. We will increasingly be told that we cannot ask questions because events are subject to commercial confidentiality. That is exactly what happened in Oxfordshire. It is a distraction from what should be happening to sort out the deficit and the proposed cuts in the Oxford Radcliffe Hospitals NHS Trust.
	Ministers should do three things. First, they should intervene in Oxfordshire and elsewhere to ensure that SHAs do not impose unrealistic targets for damaging cuts. Otherwise, slash-and-burn reductions will take place not because they make sense but because they are the easiest way to save money.
	Secondly, will Ministers please examine the formulae? My hon. Friend the Member for South-West Surrey (Mr. Hunt) and all Conservative Members would say that the Government must consider the formulae and the way in which money is allocated. It cannot be right that Oxfordshire receives only 85 per cent. of the average funding for the rest of the country. If Ministers bothered to come to Oxfordshire, they would realise that areas such as Blackbird Leys in the constituency of the right hon. Member for Oxford, East (Mr. Smith) and wards such as Ruscote and Hardwick are as socially deprived as anywhere in the country. The formula is simply not fair.
	Thirdly, Ministers must ensure that we do not continue to go through the ridiculous organisation and reorganisation of the NHS. How much money has been wasted by initially setting up many PCTs and then reorganising them into single PCTs? Moreover, Sir Nigel Crisp said at the start of the recess that PCTs would be allowed to do one thing but the Secretary of State now claims that they will not be allowed to do it. How does anyone in the NHS have any idea about what is supposed to be happening when Ministers keep chopping and changing their minds about what they expect of NHS organisation?
	I am sorry that the Secretary of State was so complacent this afternoon. Every time an operation or the NHS fails a person in Oxfordshire, I shall ensure that those people have a summary of this afternoon's debate. Labour Members got up and simply told us how wonderful things were in their part of the country. That demonstrates the two nations that the Government have created.

Kali Mountford: Again, we start a debate with collective amnesia. Hon. Members told my right hon. Friend the Secretary of State that she should not be able to sleep at night. If that is the case, Conservative Members must have had 18 years of nightmares. My hon. Friend the Member for Crawley (Laura Moffatt) gave a good account of past failings in the national health service. The Opposition have a clear strategy of running down people's opinion of the NHS to pursue a more insidious agenda. The speech of the hon. Member for Banbury (Tony Baldry) was an example of that. The debate is not genuinely about overall investment in the NHS but about certain people's concerns not being met because of a restructuring of the way in which health care is provided. Yet, if Conservative Members read some of the diaries of their right hon. and hon. Friends who used to be Ministers, they will realise that some of them openly admit political interference in the formula. [Hon. Members: "Who?"]

Graham Stuart: rose—

Kali Mountford: I shall not give way. Hon. Members can go to a library like anyone else.

Andrew Turner: Will the hon. Lady give way?

Kali Mountford: I have made it clear that I am not giving way.
	I am glad to say that I believe that the formula as it is now constructed ensures that people in the most deprived areas get the most funding. That is the right way forward. Each person in my constituency gets £7 less than in the neighbouring constituency of Huddersfield. That is hardly surprising since the economic indicators clearly show poverty in Huddersfield and relative wealth in Colne Valley. We make no excuses for that; the formula is perfectly fair.
	We have also ensured locally based provision of health services through the PCTs. All hon. Members should welcome that. Conservative Members often talk about a small state and large people, yet suddenly today, they demand state interference at the most local level. Decisions about the local delivery of services should be made locally.—[Interruption.] I am making a case.
	In my PCT, there was huge consultation about the delivery of services. Local people made clear what they wanted from their health service. Thousands of people wrote to me and a case was clearly made to the Government. The Government agreed that the services should cater to local people's needs. People understood that they could join with Huddersfield, which had more money spent on constituents per capita, yet they still preferred locally based services.

Mark Simmonds: Does the hon. Lady agree that she is making a good case for abolishing central Government targets for health care?

Kali Mountford: No, I do not agree because there must be a balance between ensuring that taxpayers' money is spent on the right priorities and local needs. There is no contradiction in stating Government priorities, which, in my experience, usually reflect the concerns of my constituents. For example, let us consider cancer care. It was clear that my constituents wanted the same rate of recovery as the rest of Europe experiences. They were not getting that but we are now well on the way to achieving our targets. I am pleased and proud about that. The hon. Gentleman makes it appear as though my constituents did not want such targets. If they had not wanted them, I would not be here today.
	We are conducting several health reviews in my constituency and I have some concerns about them. Local people should be able to make decisions, not in the interests of doctors or administrators, but in those of patients. That is why I asked the hon. Member for Romsey (Sandra Gidley) about her view of maternity services. She might be interested to learn that her colleagues on Liberal-run Kirklees council agree with me about midwife-led units. We need to learn much more about how they can play an important part in maternity services if they are properly supported. My constituents are concerned about how that service can be delivered to their benefit. Most of them want a choice in their services, and maternity services are as good an example as any of how choice can work.
	A woman who expects to have a perfectly normal birth might want to have her baby at home. That is quite proper, and she is entitled to do that. Should the community decide that it wants a midwife-led unit, it will make that case clearly to the local PCT in the local consultation. People are right to demand from me—as I demand from the health service—that such a unit be run properly and with the right support. We should not therefore set up a maternity service that delivers only 500 babies a year, when there are 3,000 a year being delivered in the Huddersfield royal infirmary. We have to take into consideration not only the number of babies being born in Huddersfield but the fact that we might also have to transfer patients, in the middle of what was expected to be a normal delivery, to the newly built hospital in Halifax, which we are very proud that the Government were able to deliver—no pun intended.
	We have to balance the new ways of delivering health and patient care with value for money and with what the public want. The public have made it very clear to me that, if there is to be a midwife-led unit, they want it to have full hospital support nearby.

David Burrowes: The hon. Lady began her speech by talking about collective amnesia. Does she share my concern about the amnesia of the Government, who, before the election, promised that the future of our local accident and emergency unit in Enfield would be safe and secure in their hands? Six months on, however, there are plans to cut that service. Is not that an example of amnesia, in that the Government now appear to support that closure?

Kali Mountford: What would be important would be for the hon. Gentleman's constituents to have a local consultation about accident and emergency services, similar to the one that took place in my constituency. The services there have now greatly improved. I can speak only for my own constituency and my own hospital, but no doubt he will make his own case for the hospital and the accident and emergency services in his constituency.
	I understand it when health managers tell me that they want to review services because they want to make them more effective and efficient, safer to deliver and better for patients. They make it clear that they are doing that not because they feel that they are underfunded but because they think that there is a better way of delivering the services. I tell them that they might be right in some cases. However, if they continue to propose new services that, in my constituents' view, favour the administration of the hospital or the doctors to the detriment of the services that my constituents want, we need to listen very carefully to the patients at that point.
	In 1996, when the then Government proposed to close the local community hospital, I opposed the closure. The hospital remained open. A clear promise was made to that effect by this Government, and the hospital has remained open. Not only that, but it is flourishing and growing daily. It provides new services that were never thought of before. It used to be regarded as quite a shabby place that the local community paid for out of donations. They felt that those donations made it their own hospital, and they were proud of it. Now, because of this Government's commitment to community hospitals, it delivers surgery day care, which it did not do before. I believe that that hospital is the kind of place that could house a maternity unit, because it would have the support of obstetricians, paediatricians and anaesthetists nearby. My constituents—and the midwives themselves—tell me that they want the kind of service that will ensure that all deliveries are safe.
	Conservative Members ignore the fact that we ought to be measuring the positive outcomes of patient care. Patient care changes and develops over the years, and it becomes better. As it does so, we have to adapt to the introduction of new services or treatments or—I have forgotten the other word.

Edward Vaizey: Cures.

Kali Mountford: The hon. Gentleman has helped me greatly.
	As medicine changes, we have to change with it, but we must not be led by the nose into thinking that there is only one way of doing things. Services must be locally based and they must respond to local needs. Our consideration of cost-effectiveness must take into account patient outcomes. "Patient outcomes" sounds like horrible management-speak for people getting better. If we look at the number of people getting better, we can see that thousands more people are being treated—

Mr. Deputy Speaker: Order. The hon. Lady's time is up.

Julian Lewis: I hesitate to give advice to the hon. Member for Colne Valley (Kali Mountford). She has many admirers on this side of the Chamber, and I think that I am right in saying that she entered the House at the same time as I did in   1997. I would merely say to her that in the 1997 Parliament it was acceptable for Labour Members to argue that everything was the fault of the previous Conservative Government. In the 2001 Parliament, it was arguably acceptable for that to happen. However, this is the 2005 Parliament and it is incredible to argue that this is all the fault of a Conservative Government who lost power way back in 1997.
	Before I leave the party political part of my speech, I must point out that I would never have imagined that, six months after a general election that the Government won with a majority of 60, the best that the Government could do in a major Opposition day debate would be to get only four Back Benchers—including one whom I believe to be a Parliamentary Private Secretary—to support their ministerial team. It is a sign that all is not well with this Government.
	My final point about the hon. Member for Colne Valley is that it is precisely because we like and admire her that it is sad to see her having to speak so defensively about a record that she knows in her heart is not satisfactory. I would not discourage her from doing that because, as time goes on, if the Government continue to try to purvey a message of good news to a country that knows that the news is thoroughly bad they will simply lose credibility.
	I come now to the events in the constituencies of New Forest, East, New Forest, West, and Romsey, to which the hon. Member for Romsey (Sandra Gidley) briefly referred. I thank her for the way in which she has co-operated with my hon. Friend the Member for New Forest, West (Mr. Swayne) and me in fighting to save the five community hospitals based in our three constituencies. I was sorry to hear the spat between my hon. Friend the Member for Reigate (Mr. Blunt) and the hon. Member for Crawley (Laura Moffatt) about the fight over which community hospital should be saved in their constituencies. The reality is that if constituencies work together, they maximise their chance of saving all their community hospitals, because this is not a zero-sum game.
	When I asked the Secretary of State whether she valued the role of community hospitals I expected her to say yes. However, I also hoped for an answer to the question whether she thought that their closure was a matter of dogma or of economics. It should not be a matter of economics. During our campaign against the closures—which is not over yet, although things are now looking promising for the five hospitals—we discovered that the running of the community hospitals accounted for between only 1 and 2 per cent. of the total operating costs of the PCTs concerned. Those PCTs admitted, without too much pressure, that the reason they were in gross financial deficit had nothing whatever to do with the cost of running the community hospitals. I am only sorry that the Secretary of State was not prepared to concede that point when I asked her to do so.
	The reality was that five community hospitals were to be closed. There was, however, supposed to be consultation and originally it appeared that the consultation would be on all the possible options. Option one out of five was to keep all the beds, or at least some of the beds, in all the community hospitals. Option five was to close all the beds in all five hospitals. In between, there was a series of cunningly designed options, such as closing one hospital but keeping others open, or closing two hospitals but keeping others open. It was patently obvious what was being planned. The idea was that the consultation would set hospital against hospital, community against community, and then the PCTs would be able to go back and say, "None of the communities can agree on which of their hospitals should survive, so we will just do what we consider best."
	What did the PCTs consider best? Extraordinarily, when the truth was told, they did not like the idea of people being treated in community hospitals. Indeed, one non-executive director of the New Forest PCT, who subsequently became acting chairman for a period, said at an early meeting that treating people in community hospitals rather than in their own homes was archaic. If we wish to develop services to encourage people to be treated in their own homes more than at present, the best way to do that—after all, people do not go into hospital for fun—is to persuade them that if the time comes when their condition deteriorates to the point that they will need in-patient care, those in-patient beds will be available.
	I wanted to finish with a few tips and hints for people campaigning on these issues, but something strange is going on nationwide. It is not clear whether it is a movement among PCT bureaucrats or whether they are being surreptitiously encouraged by the Government. The Government say that they value community hospitals and I would like to believe them. If they do, the movement is among bureaucrats. Whatever, there is an attempt to say that community hospitals are not necessary and that people can be treated at home. That smacks of something that we have seen before—what happened to mental health services when care in the community swung the pendulum too far against professional care in institutions.
	There is a grain of value in what is being recommended, but the reality is that valued, trusted and loved organisations will be thrown away for the sake of dogma. When that dogma is found to have failed, the unelected bureaucrats, whom no one put into power except the Government, and whom no one can remove except the Government, will no longer be there. It is no good the Government saying to us that such decisions must be taken locally—our answer is that such decisions must be taken democratically.

Richard Taylor: While I welcome the extra money going into the health service and some of the improvements that have occurred, I find it incredibly hard to understand why only a quarter of trusts are in deficit, when in my area all three of the primary care trusts and the acute trust are desperately in deficit. I want to try to persuade the Government to admit that at least some of the deficits are their fault.
	At the Health Committee last week, I asked a chief executive of a strategic health authority:
	"is it not also part of your job to tell the Government that with Agenda for Change, GP contracts, consultant contracts, out-of-hours care and all these further reconfigurations, that even though they put extra money in, you do not have enough?"
	He replied:
	"you are absolutely right that if you look at those examples you gave, whether it is Agenda for Change, the consultant contracts, the GP contracts, all of those cost more money than we originally identified in the arrangements to do it, and we make that very clear to Sir Nigel Crisp and his team when we meet them."
	The Government must therefore be aware that some of the deficits are due to their plans.
	As an independent Member, I have the immense privilege of being able to attack both the previous Government and this Government. I refer the House to an article in the Journal of the Royal Society of Medicine in 2003, which reviewed all the changes imposed on the NHS up to that date, which it called, "organisational upheaval". I am glad to tell the House that the score is 13 to 12 in the Government's favour, or rather disfavour. From 1982 to 1996, there were 12 reorganisations. From 1997 to 2003, there were a further six. By my counting, since 2003, seven or eight more have taken place. The author of that article concluded:
	"perpetual reform is very costly, both in terms of the time and effort invested by managers and other NHS staff, and in terms of the financial costs of establishing the physical fabric of new organisations and of meeting the redundancy or retirement costs of displaced staff."
	The NHS staff who speak to me, locally and more widely, make a sincere plea, "Leave us alone. Let us just do our job of caring for patients. And please slow the reforms."
	As I said in a debate in Westminster Hall this morning, one of the consequences of deficits in my area is that the acute trust is £20 million to £30 million short. Some of that is because of inefficiency, and I welcome the drive for efficiency-increased productivity. I am saddened, however, that there are threats, yet again, to hospital services in my county.
	Apart from threatened reconfigurations, the PCTs have deficits, which affect me and, I suspect, other hon. Members in the form of battles with NICE guidelines. I have had a tremendous battle to get funding for the anti-TNF drugs for rheumatoid arthritis, which are approved by NICE. I am having a battle over biventricular pacemakers, which every cardiologist reckons are far better than the old-fashioned pacemakers, and yet a patient must go before a special complex case panel to be approved to have what is well known to be the most effective form of pacing. There is, of course, a battle over Herceptin, and in my area each case is being examined specifically. There is NICE blight, whereby things that are about to be tested are not even considered by PCTs. Then there are things that are not even on the NICE list, such as the treatment for sleep apnoea. Any Members who are overweight and whose wives tell them that they snore loudly might need that treatment at some point.
	My plea is that we should recognise the causes of the deficits, slow down some of the reforms and give the staff time to care for their patients. It is all very well to rule that GPs must do Saturday morning clinics. But who stopped the Saturday morning clinics? The Government accepted the new GP contract, which did just that.

Paul Burstow: We have established that the proposition of the chief executive of the NHS that this is a year of financial correction is a rather useful euphemism for describing the build-up of pressure in the national health service that is causing so much difficulty on the ground, not just for those who are struggling with balancing their budgets but, more importantly, for those who are suffering the consequences of services being dislocated and cut.
	By month five of the current financial year, Sutton and Merton PCT, in my area, was already forecasting its current £1.3 million deficit, and it is now forecasting a £5.2 million deficit by the end of the year. As we have heard, however, those figures mask the true magnitude of the problem and the pressures faced by PCTs and other NHS organisations. Notwithstanding its deficit, my PCT has been told by South West London strategic health authority to achieve a surplus of £6.7 million to help bail out other parts of the NHS locally. That means that a gap of £11.9 million must be closed before the end of the year. Moreover, it must all be seen against the PCT's opening deficit of £7.4 million, which in the past year has been funded through non-recurring items such as cuts and delays in projects.
	The Secretary of State suggested that the NHS was all right because many NHS organisations broke even. What she forgets is that while they may break even on 31 March, on 1 April their debt is back around their necks, causing difficulties for their organisation and the recovery plans on which many fail to deliver. Most of the deficit on my patch arises not because of management failures and non-provision of services, but because of the challenge to NHS managers and staff to meet the access targets with which the Government confront them. It is a case of over-performance—a lovely phrase that is used when a hospital carries out more operations than was intended during a particular fiscal year. A hospital that provides more treatments becomes a target for pressures to cut budgets and spending. That is another example of historic underfunding of the NHS.
	It is against that backdrop of funding pressures in my local health economy that my local health service proposes to close two district general hospitals and replace them with a smaller critical care hospital with fewer beds, underpinned by a network of local care hospitals that will have no beds at all. I fear that that network will never exist. A critical care hospital will open in due course, but it will not provide a satisfactory service without the support of the network because the PCT will not be able to invest in the services that would enable it to operate properly. I hope that the Minister will assure me that the "Better Healthcare Closer to Home" programme on my patch will deliver in full for my constituents and will not leave the legacy of a critical care hospital bursting at the seams because it did not receive the primary care and diagnostic services that it needed.
	Let me say something about the wider position in London. The Secretary of State told us that most NHS organisations were not in deficit, but that clearly does not apply to London. Of the 42 NHS organisations providing acute and mental health services, 23 are in deficit, according to their final accounts as recorded recently. It seems that the NHS in London faces a £94 million deficit, with which it must grapple during the current financial year. That is a huge drag on it.
	The problem with debates such as this is that they are clouded by inadequate reports from SHAs about the true position. The lack of numbers in some of the reports submitted by their boards, and the obscurity surrounding the level of risk, beggar belief and do not provide a framework in which accountability can exist and Members in all parts of the House can scrutinise the performance of their NHS organisations.
	North West London SHA is a case in point. Having been warned consistently by Kensington and Chelsea PCT that the PCT had been in deficit last year, in September, December and February this year the SHA was still reporting that it would break even by the end of the financial year. Then, there was the big surprise at the end of the year when the PCT found itself in a huge financial mess.
	All that demonstrates an inherent problem with which the Government have failed to deal. The growing instability in NHS finances will be amplified by the roll-out of payment by results. As a consequence, more NHS organisations will be in difficulty and will struggle to balance their books. The Secretary of State assures us that the present deficit is containable and manageable. She fails to point out, however, that organisation of the NHS is in transition—that it is on the way to becoming a market model and that the deficits will matter far more when the transition is completed. The demand side of the service now holds the whip hand, the commissioners have not been given the strength to do the job, and the Government's proposals for PCT reorganisation have come too late. They have woken up to the problem, but they are shutting the stable door when the horse has bolted way ahead.
	The Government's general election manifesto proposed a £250 million or 15 per cent. saving through NHS reorganisation. The final twist came in Sir Nigel Crisp's statement, reported last week, that the NHS planned to increase the role of SHAs and not to allow the new PCTs full control over their budgets until they could demonstrate their ability to deliver their financial plans. Effectively, that constitutes centralised control over NHS finances. The Liberal Democrats do not want it, but the Government seem content to allow it.
	I hope that the Minister will give reasons for the proposed change and centralisation. As we approach a year in which funding gaps are widening, the Government propose to reduce funding after the growth of the past few years. I fear that we will have not a soft landing but a rough landing, and that unless the Government get a grip we will have a real problem.

Mark Simmonds: I agree with my hon. Friend the Member for Banbury (Tony Baldry) about the deplorable complacency of the Secretary of State's speech. She wanted to talk about anything other than the motion, and her responses to the serious points made by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) were unacceptable. I can be more positive about the hon. Member for Colne Valley (Kali Mountford), who made a typically articulate speech. She made a good case for the abolition of central Government targets. Along with the Government's manipulation of the funding formula, mentioned by my hon. Friend the Member for South-West Surrey (Mr. Hunt), those targets are the main reason for the terrible deficits that most PCTs are now experiencing.
	I warned the Government that they would find themselves in this position as long ago as November 2001, when I initiated an Adjournment debate in Westminster Hall on the future of Skegness and District hospital. I asked the Minister to reassure my constituents and me that when the PCT ran short of money, it would not close wards. What safeguards would the Government introduce to ensure that wards would not be closed and beds would not be lost? The then Minister of State, the right hon. Member for Redditch (Jacqui Smith)—who, rather worryingly, is now Minister for Schools—replied
	"I reassure them and him that they need not fear for the future of what is an excellent community hospital: there are no plans to close or to downgrade it."——[Official Report, Westminster Hall, 13 November 2001; Vol. 374, c. 237WH.]
	On 1 November this year, one ward—50 per cent. of that hospital's wards—closed.
	In January 2003, I initiated an Adjournment debate about the future of Pilgrim hospital, the main hospital in my constituency. I asked the then Minister, the hon. Member for Tottenham (David Lammy) to reassure me that there would be no downgrading of facilities at that important hospital in my constituency. He said
	"I want to assure them from the outset"
	—"them" being my constituents—
	"that they need not fear for the future of their hospital or the future of the NHS under this Labour Government."—[Official Report, 16 January 2003; Vol. 397, c. 919.]
	This summer, two wards in Pilgrim hospital, Boston closed, losing 59 beds—another disgrace.
	I held a debate in July this year, to which the Under-Secretary the hon. Member for Birmingham, Hodge Hill (Mr. Byrne) replied—I see him in his place. I have to say that his response that day was at least more articulate and sensible than either of the two responses that I had received in the previous debates— [Interruption.] Not only did he go to Harvard, he also had an interest in Lincolnshire church architecture, which means that he cannot be all bad. I pointed out that the Government had failed to act in time to stop the ward closures and asked him to put on record his assurance that there would be no further diminution of health care provision in my constituency or elsewhere in Lincolnshire. Even that Minister, however, failed to do so.
	My hon. Friend the Member for South-West Surrey may not have known it, but he hit the nail right on the head. In my view, there has been a deliberate policy by the Government to manipulate the public sector funding formula not just in the health service, but across the public sector, to move resources—particularly out of rural areas that have Conservative and sometimes Liberal Democrat MPs—in order to benefit their own MPs, especially in marginal seats. The hon. Member for Wirral, West (Stephen Hesford) has effectively confirmed that today.

Jeremy Hunt: Is my hon. Friend aware that the Government have changed the funding formula for the NHS four times since 2001 and that in every single year, they have increased the relative weighting given to social deprivation and decreased the relative weighting given to age and the cost of delivery of local health care?

Mark Simmonds: I am aware of that; my hon. Friend is absolutely right. The crux of the matter is that it is not only areas represented by Labour Members that have pockets of socio-economic deprivation. That needs to be recognised, alongside the sparsity factor, the increasing population and the increasing age of the population.
	I represent a constituency on the east Lincolnshire coast, which has a significant number of retired people, particularly those coming from the ex-coal mining constituencies of the midlands, who bring their health problems with them. That needs to be reflected in the funding formula: it is not, but it needs to be. I am not saying that Skegness or the east Lincolnshire coast is alone in that problem; it needs to be recognised around the whole country, where appropriate.

Graham Stuart: Through you, Mr. Deputy Speaker, may I thank my hon. Friend for becoming a patron of CHANT—the community hospitals acting nationally together campaign group—which was formally launched today? I hope that, he, together with my hon. Friends, Government Members, Liberal Democrat Members and the independent Member will demonstrate their support for CHANT. The same applies in respect of the other place. We are gaining cross-party support for what is a national problem and we need Ministers to respond to it.

Mark Simmonds: I congratulate my hon. Friend on all the work that he has put into getting the CHANT group off the ground. He deserves significant recognition across and outside the House. I am sure that he will be rewarded in his own constituency for the efforts that he has made. I am delighted to see the Conservative Benches so full today: many more Conservative Members will be engaged in improving the provision of health care, not just in our respective constituencies but across the country. The representation on the Government Benches this afternoon provides a marked contrast.
	I want to provide some brief statistics to show the consistent underfunding of the East Lincolnshire primary care trust, which serves my constituency and that of my hon. Friend the Member for Louth and Horncastle (Sir Peter Tapsell), who I am delighted to see in his place. The PCT began on 1 April 2002 with a £2.8 million debt inherited from the former Lincolnshire health authority. In the year 2005–06, it was 8 per cent. off its target share of funding. As much as 36 per cent. of the total underfunding in the Trent strategic health authority area is applicable to the East Lincolnshire PCT, which is one of the 10 worst funded PCTs of the 303 in England. This year, it is £30.3 million below its target level funding.
	It is not only the East Lincolnshire PCT that is underfunded; they all are in Lincolnshire. The United Lincolnshire Hospital NHS Trust is £8.1 million in deficit with a £20 million predicted shortfall this year. That has meant two ward closures and 59 beds lost at the Pilgrim hospital and 15 beds, including three palliative care beds, in the Scarborough ward closed on 1 November. As you can imagine, Mr. Deputy Speaker, there was absolute uproar in Skegness, resulting in very well attended public meetings—[Interruption.] Government Members are laughing, but this is a very serious issue. The meetings culminated in setting up adelegation that is coming to Parliament on 30 November. I ask one of the relevant Ministers to meet that delegation—it will include Labour councillors who attended the Secretary of State's surgery but, needless to say, received no response from her—and hear what it has to say. The losers are people living on the east Lincolnshire coast who need that facility. Pilgrim hospital is 42 minutes away along the A52.
	Due to pressure from myself and others, future funding was supposed to increase from April 2006—by 13.6 per cent. that year and 12.4 per cent. the following year. It has now become clear, however, why the Government were prepared to acquiesce in that increase in funding. It is because there is going to be a reorganisation, so the PCT may never see the additional money, which may even be transferred from where it was originally going to be spent. In winding up today's debate, will the Minister give an assurance that the money promised will remain in the original area of the East Lincolnshire PCT and that the SHA will permit it to be committed prior to the reorganisation in April 2006?
	The two specific problems that I have mentioned are the culture of targets and the manipulation of the funding formula. If only it were as simple as that, but unfortunately, the ambulance trust is now under pressure and it has been proposed that 28 ambulances in Lincolnshire and 42 front-line staff should go. It is ironic that I received a letter from Unison, pleading for my support to fight Government cuts in Lincolnshire. What an irony.
	In conclusion, councillors in my constituency have informed me that the Government blocked the acceptance of the local authority's offer to fund the reopening of the ward—they did so for political reasons, as they do not want to alert the electorate to the fact that the NHS in Lincolnshire is underfunded—and thereby ensured the closure of the Scarborough ward in Skegness. I am also told that the Government are politically interfering and manipulating the strategic health authority and the primary care trusts right from the heart—pressurising staff, demanding clearance for all information flows, including for MPs, and blocking spending plans. If true, that is totally unacceptable in what is supposed to be a devolved, patient-receptive NHS.
	I want to see health care provision improved in Lincolnshire and elsewhere—not just in areas represented by my right hon. and hon. Friends, but across the United Kingdom. We must all ensure that that happens. Unfortunately, because of the way in which the Government are managing the NHS, it is not.

Mark Hoban: I welcome the opportunity to debate the financial deficit in Hampshire, which particularly affects my constituents. My hon. Friend the Member for New Forest, East (Dr. Lewis) referred to the problems of community hospitals in that part of the county. In a way, Mr. Deputy Speaker, I wish I had a community hospital. The problem in Fareham is that, despite recognition for some years that local people need a community hospital and despite the record investment in the NHS to which the Government refer in the amendment, no community hospital will be forthcoming for the next two or three years at least.
	What we have seen in Fareham is a much-loved popular local facility—the Blackbrook birthing centre—closed at short notice. I referred to it in an earlier intervention on the hon. Member for Romsey (Sandra Gidley). The Blackbrook birthing centre in my constituency has provided care to mothers—many of whom were born there—for many years. It provides mothers who have given birth elsewhere in other units run by the Portsmouth Hospitals NHS Trust the opportunity to go back for some post-natal care for two   or three days to help them to bond with their children. Mothers have also used the centre to receive the hands-on practical advice and care that midwives can give in that unit, which they cannot get elsewhere.
	In July this year, the centre was closed with only two weeks' notice. Mothers who had booked to give birth there were told at short notice that they were no longer able to do so because of the combination of staff shortages through sickness and midwives going on maternity leave. Naturally, it was disappointing for mothers to be told that they could not have their children there, but it was also disappointing that the trust did not recognise the problems that the pregnancy of midwives themselves could cause, and that it had to close the unit at such short notice.
	I am afraid that this is not the first time that the birthing centre has been closed for those reasons. Having been closed since August 2000 because of staff shortages and sickness, it reopened in June 2001, only to close again in January 2002, until May of that year, again because of staff shortages. Mothers in my constituency are an easy target. They are the first to feel the pinch when there is a shortage of midwives in the local PCT.
	Recognising the great outcry across the community at the closure of Blackbrook, the trust committed itself to reviewing the question of its reopening in December, and it pressed ahead with recruiting midwives, despite staffing pressures elsewhere in the system. It agreed to recruit 12 whole-time equivalent students and five other midwifery posts, so that Blackbrook—and the Grange maternity centre, which is in the constituency of my right hon. Friend the Member for East Hampshire (Mr. Mates)—could reopen by the turn of this year.
	Local parents have campaigned vigorously to keep both centres in the public eye. I congratulate the "Friends of Blackbrook" and Mel Watson on their excellent work in keeping Blackbrook in the public eye and that of the people of Fareham. But they were stunned, as was I, to discover in September that the trust had postponed the reopening of Blackbrook and the Grange, because it recognised that the financial constraints that have affected all Hampshire's trusts have to be applied to maternity services as well.
	In a letter to me, the director of clinical services, nursing and midwifery said:
	"You will also be aware of the difficult financial situation affecting both the Trust and all of Hampshire and the Isle of Wight . . . The Board agreed that Maternity Services must now be subject to the same financial controls as all other Trust services, even though this may mean the reopening of Blackbrook and the Grange might be delayed as a result."

Maria Miller: I draw to my hon. Friend's attention the fact that the financial crisis in maternity care stretches as far north in Hampshire as Basingstoke, where we have no 12-week scans for pregnant women. The financial crisis has hit us hard as well, and it is interesting to hear how it is stretching further south.

Mark Hoban: Indeed; the problems affecting maternity services stretch right across Hampshire.

Michael Mates: Not only were we subjected to the constraints to which my hon. Friend referred; it had been specifically denied only weeks beforehand that there were any financial disadvantages in reopening the Grange and Blackbrook. The only reason given for the decision was clinical safety, which was patently untrue.

Mark Hoban: Indeed. The problem is the continuing uncertainty about the future of the two centres. Despite the trust saying that it will review the situation at the end of the financial year, there is no guarantee that either unit will reopen. It is important that people maintain pressure on hospital trusts when facilities are closed temporarily. My constituents and I fear that at times, such temporary closures are a precursor to closure by stealth—that such closures will last longer and longer, so that the public scrutiny to which a formal closure should be subject goes by the board.
	I am grateful to the Hampshire county council overview and scrutiny committee, led by councillor Ray Ellis, for its continuing vigilance on this matter. It is making sure that there is no chance that such facilities will close without the public becoming involved, or without proper consultation taking place.

Iris Robinson: Will the hon. Gentleman give way?

Mark Hoban: I would like to give way, but other Members wish to take part in this debate.
	My hon. Friend the Member for Basingstoke (Mrs. Miller) referred to scans, but another related issue that has been brought to my attention is the denial of in vitro fertilisation treatment to would-be mothers across Hampshire. Despite Government guidelines and action taken by the Secretary of State last year to commit to providing one free cycle of IVF treatment to Hampshire's would-be mothers, the PCT has denied that opportunity to those who are perhaps most in need of IVF treatment. The reality is that that opportunity has been denied them because of the financial problems that PCTs in Hampshire face. The deficits are restricting the treatment available to those who want to have a baby.
	The Government talk in their amendment about record investment in the NHS, but the experience of many of my constituents—such as mothers who want to use birthing centres, access maternity care or have IVF treatment—is that that investment is not reaching the people of Hampshire. They cannot understand how the Government's promises and spin can be reconciled with the reality on the ground, and the same is true of constituencies elsewhere in Hampshire.

Stewart Jackson: I am grateful for the opportunity to share with the House the impact of this Government's incompetence and mismanagement on my constituents. In so doing, I pay tribute to the staff and management of my local NHS trusts—the Peterborough and Stamford Hospitals NHS Foundation Trust, and the Greater Peterborough Primary Care Partnership—whose professionalism is enabling them to continue to put patients first, notwithstanding the Department of Health's strategy of buck-passing and neglect. That said, people in Peterborough are fighting back to defend their local NHS facilities. Mary Cook, a former nurse from Orton Goldhay, which is in the constituency of my hon. Friend the Member for North-West Cambridgeshire (Mr. Vara), has collected thousands of signatures in protest at ward closures, cuts in bed spaces and the amalgamation of our local PCTs.
	Mary Cook is not a Conservative, but she is a special lady. In 1996, she won a national newspaper competition, which enabled her to meet the then Leader of the Opposition, the right hon. Member for Sedgefield (Mr. Blair), and to quiz him on the NHS and how his policies would help Peterborough. At the time, she said that she was satisfied with his response. What is her view today? Last month, she told Peterborough's The Evening Telegraph,
	"Looking at his answer now just makes my blood boil. He has more or less gone against everything he told me."
	In April 2000, the right hon. Member for Sedgefield, upon the occasion of the opening of a new NHS walk-in centre in my constituency, told the very same newspaper—in breathless, messianic prose that was doubtless written for him:
	"Not for the first time, the city is blazing a trail for others to follow. You can't rebuild the NHS overnight . . . what you can do is put in the investment and the reforms to get it right."
	So what is the Prime Minister's legacy to my constituents? The Peterborough and Stamford hospitals trust is predicted to be £7.7 million in deficit at the end of this financial year. It has already axed 70 jobs and closed no fewer than three wards and 106 beds. A further 200 jobs are under threat, and cuts of £6.5 million are in the pipeline. Just yesterday, following the local PCT's decision to withdraw £2.5 million-worth of funding, the trust has been ordered to "slow down" elective surgery cases, thus increasing waiting lists and making further cuts inevitable. The Department of Health is happy to preside over the disintegration of local NHS services. It is pressing the trust to meet its statutory obligations under legislation dating from 1990, but it is happy to carry over accumulated structural debt. This dichotomy is unsustainable in its present form.
	What is the trust to do? It is faced with external demands—such as consultants' contracts, agency staff, the European working time directive, initiatives such as "Agenda for Change", and a hugely increased drugs bill—but it has not been provided with adequate funds to meet them. Ministers have not addressed this issue.
	Even when the Government try to involve the private sector, they are noteworthy for their incompetence. Part of the reason for the structural deficit in Peterborough is the mismanagement of the private finance initiative scheme for the building of a new super-hospital in Bretton Gate, on the site of the Edith Cavell hospital. Initially, the cost to the trust of the project's consultants—more than £5 million—was to be underwritten by the Department of Health. Then, it was not. Then, just £1.9 million was to be underwritten. Then, the whole amount was again to be underwritten. Last week, the hospital trust's chief executive warned:
	"We cannot keep running at a loss. We want to give advance warning that jobs are at risk."
	The PCT will fare little better, with a forecast deficit of £4.2 million this year. Its chief executive said that the trust was in a "fragile financial state", with a vacancy freeze and staff morale at rock bottom.
	Meanwhile, patients face longer waiting lists and further cuts in service provision. My constituent in Walton was forced to wait 88 weeks to have a new digital hearing aid fitted at the audiology department—so much for the public-private partnership, and for the Prime Minister's honeyed words.
	The problems that I have described are the results of centralised planning and 300 targets. The Secretary of State's approach is similar to that of Stalin's approach to tractor quotas in the Ukraine, although she does not have his sense of humour, flexibility and sureness of touch.
	When will the Government concede that their star rating system is flawed and inaccurate? When will they learn that targets distort clinical priorities and disadvantage patients who need non-targeted, elective surgery but who get pushed to the back of the queue?
	The drive to a monolithic culture, disdainful of the views of local people, continues with the Orwellian behemoth that is known as "Commissioning a Patient-Led NHS". That is newspeak, or doublethink. The plans mean that my constituency has taken on a contingent deficit of £23 million from South Cambridgeshire, and they take no account of patients or professionals.
	Does the Department of Health care that there are major health inequalities in my constituency? Adult life expectancy is four years lower there than in neighbouring Cambridge, and the local PCT has unique health needs and specialties. It is rare for me to make common cause with Unison, but I applaud the union's efforts to defend local health care in my constituency.
	It is time for the Government to acknowledge the crisis, and the fact that they do not have any moral superiority or a monopoly on care about the NHS. Until they do that, we will see more wards closing and more bed spaces lost, rock bottom staff morale and further suffering for my constituents and for people across the country.

Tom Harris: They should get a better MP.

Mr. Deputy Speaker: Order. I do not expect such comments from Back Benchers, and especially not from a Parliamentary Private Secretary.

Stewart Jackson: That passes for rapier wit in Glasgow.
	What price the Prime Minister's honeyed words and promises today?

Nick Herbert: The Secretary of State gave the clear impression that the deficits described by other Opposition Members do not matter. She said that they affected only a small minority of trusts, but all four acute trusts serving my constituents in Arundel and South Downs are in deficit. The Brighton and Sussex University Hospitals Trust has a deficit of £7.5 million, and that will double by April. The St. Richard's hospital in the south-west of my constituency serves my constituents in the Royal West Sussex Trust and has a cumulative deficit of £20 million, and rising. The Surrey and Sussex Healthcare Trust has been referred to already and has a deficit of £29 million, while the Worthing and Southlands Hospitals Trust has a deficit of £5 million, which is forecast to rise to £13 million by March. That represents a total deficit of more than £60 million, and rising, in the acute trusts in West Sussex alone—hardly a chimera.
	That deficit affects the trusts' creditors; it is not merely a paper deficit. Ministers will know that many of the trusts are unable to meet their bills, and that means that creditors, including those in the private sector, are being made to wait for payment.
	The Secretary of State said that a recovery plan was in place. What does that plan entail in West Sussex? In Worthing and Southlands, it means that two wards will be shut. In the Royal West Sussex Trust, one rehabilitation ward is to be shut, with the consequence that patients are being transferred to Arundel community hospital. That hospital is being told that it can treat fewer local patients than would otherwise be the case.
	In 1932, people in Arundel supported the building of the hospital by public subscription. The bricks were paid for by everyone contributing sixpence each to the building fund. Local people have contributed every year to ensure their community hospital's preservation, and they feel very aggrieved that, in effect, it will be taken away from them.
	In the Brighton and Sussex University Hospitals Trust, accident and emergency services and major trauma services are being transferred from the Princess Royal hospital in Haywards Heath to the Royal Sussex hospital in Brighton. Again, that is strongly against the wishes of people in the local community.
	The Secretary of State gave the game away when she said, on the "Today" programme in June, that some parts of the NHS were "not particularly efficient". She said that
	"individual hospital departments, if they are not able to . . . balance their books . . . will find themselves replaced".
	Is it not clear, therefore, that the recovery plan really amounts to a closure plan? However, when the Secretary of State says that trusts are not being efficient enough, that is to ignore that the St. Richard's hospital in my constituency is one of the most efficient in the country. It is among the top 15 per cent. of NHS trusts nationally, and has accumulated two of the three possible stars in the Healthcare Commission ratings, yet the Government say that it is not efficient. The truth is its efficiency is being penalised by the deficit that it should not be running up.
	The Secretary of State said that deficits were rising in spite of higher resources, but the point is that, in effect, those resources are not available. The King's Fund has pointed out that 73 per cent. of spending increases are being absorbed in cost pressures. Professor Nick Bosanquet of Imperial College has said the same—that 70 per cent. of annual spending rises are being absorbed by inflation.
	The Government have fuelled inflationary pressures in the NHS, and made it less possible for trusts to meet their bills. That is not merely due to an increase in existing salary costs as a result of "Agenda for Change" and the new consultant contract: it is because the future spending commitments taken on by the Government are not properly accounted for. They include the PFI schemes, the new primary care contract that is being introduced, and the fact that more staff will be taken on.
	Professor Bosanquet has estimated that, in five years, the additional costs will amount to £10 billion a year. That will be funded from within existing NHS budgets, at a time when the increase in spending will be slowing down. By then, our health funding will be nearing French levels. It will account for 10 or 11 per cent. of gross domestic product, but the NHS will face a French-style financial crisis.
	Hospital managers have no control over those costs, which in effect are being imposed on them. In a national system, they have no way to vary the costs, and the possibility that they might be able to has been taken away. The right hon. Member for Darlington (Mr. Milburn) proposed the introduction of foundation hospitals, but that innovation never saw the light of day.
	There will, of course, be less in the way of resources for health care if the money being put in is not matched by output. The Treasury's initial measure of NHS productivity showed that it fell by a staggering 15 to 20 per cent. between 1997 and 2003. The Office for National Statistics was told to recalculate the measure, but even its revised figures show that productivity has been falling by as much as 1 per cent. a year since 1997.
	Falling productivity means that the NHS needs more resources just to stand still. One reason for that fall in productivity is that there has been an increase in non-productive activity. For example, the latest ONS figures, published last month, show that the number of managers in the NHS in England is increasing three times as fast as the number of clinical staff—that is, doctors and nurses.
	The problem is not that more money has not been put in, but that the money has been put in ahead of reform and consequently dissipated. Higher spending has simply fuelled higher costs. The national problems are exacerbated in West Sussex, where our population is rising, and relatively elderly. As Opposition Members have pointed out, the NHS funding formula discriminates against the south-east.
	I hope that the Secretary of State and her fellow Ministers recognise that the hospitals in my area face serious problems that must be answered.

Andrew Murrison: We have a had a good debate, with 13 contributions from Back Benchers, almost all of which have been good and which, in their own way, have had something to add to the debate. However, I have to say that the debate has been rather better supported by Conservative Members than by Labour Members.
	The debate started with a contribution from the hon. Member for Romsey (Sandra Gidley), although it was a pity that we did not hear from the hon. Member for Northavon (Steve Webb), especially as he has Thornbury hospital in his constituency. It is a community hospital near Bristol, and I would have thought that the hon. Gentleman might have liked to talk a little about it.
	The hon. Member for Crawley (Laura Moffatt) gave us a revisionist romp through the NHS, although my recollection of working in the NHS is rather different from hers. My hon. Friend the Member for Eastbourne (Mr. Waterson) talked about the effect of deficits in an area with an elderly population and needs that may surprise Labour Members. The hon. Member for Wirral, West (Stephen Hesford) did not mention the closure of wards 6 and 7 of Victoria Central hospital, despite being prompted by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) in his opening remarks. My hon. Friend the Member for Banbury (Tony Baldry) talked about the outsourcing of resources and NHS reorganisation, including the fact that it may act as a distraction to achieving a reasonable balance sheet and to achieving for patients.
	The hon. Member for Colne Valley (Kali Mountford) made some thoughtful points about maternity services, if I can say so without flattering her too much. That theme was taken up by my hon. Friend the Member for Fareham (Mr. Hoban), who talked about Blackbrook maternity hospital, which has a special place in my heart because it is where my fifth and final daughter was born five years ago—

Andrew Lansley: So far!

Andrew Murrison: My hon. Friend tempts me. As I was saying, Blackbrook provided excellent care for Henrietta, my wife and me.
	My hon. Friend the Member for New Forest, East (Dr. Lewis) gave us some helpful campaigning tips on how to secure the future of one's community hospital and, having visited his area, I hope that his forceful local campaign will ultimately be successful. I am sure that it will. The hon. Member for Wyre Forest (Dr. Taylor) was as sage as ever and reminded the House that Ministers have recently applied their micro-management of the NHS to reinstate GP Saturday morning surgeries. He also reminded us that it was the Labour party that removed them in the first place.
	The hon. Member for Sutton and Cheam (Mr.   Burstow) expressed concern about Sir Nigel Crisp's announcement last week that he will hold back powers from PCTs at strategic health authority level—concerns that we share. My hon. Friend the Member for Boston and Skegness (Mark Simmonds) will lead a delegation from Skegness—I hope that the Minister will meet it—in support of his community hospitals. My hon. Friend the Member for Peterborough (Mr. Jackson) talked powerfully about the effects of PCT deficits in his area and the causes of them. Finally, my hon. Friend the Member for Arundel and South Downs (Nick Herbert) discussed his concerns about service cuts in his constituency and the underlying reasons for them, which are familiar to all of us who face that problem.
	Nobody disputes the Government's good intentions and they certainly put our constituents' money where their mouth is. However, health outcomes have improved only marginally since 1997 and have, in some instances, declined. International comparisons of mortality and morbidity are unflattering to the UK and output, according to the Office for National Statistics, has fallen.
	The Secretary of State wants views on health outside hospital to inform a White Paper, which we understand will be delayed, although we will probably get it at some time in the new year. In the meantime, I wonder what the outcome was of last month's faintly sinister and highly selective deliberative exercise, "Your Health, Your Care, Your Say". The Department must surely by now have some feedback, so perhaps the Minister can share it with us. We understand that the 1,000 or so participants in that jamboree said that they wanted services closer to their communities. Well, there's a surprise. One did not need to spend more than £1 million to discover that. I could have told the Government that for free from what I hear day in and day out in my constituency. Doubtless, we will hear other startlingly obvious revelations with an extraordinary price tag. I resent that spending, because the apparent £1 million cost of the exercise in Birmingham is approximately the sum necessary to keep my community hospitals, which are threatened with closure, open for a year.
	That brings me neatly on to one of the main consequences of PCT deficits that has been raised today. It was the subject of a well attended meeting upstairs this morning and the mission of CHANT or Community Hospitals Acting Nationally Together. I confess that that is a tortured acronym—for which we are indebted to my hon. Friend the Member for Beverley and Holderness (Mr. Stuart), who is heavily bandaged at present—but it grows on one. I hope that it will appeal to the Minister and I am sure that she will hear more of it in coming weeks.
	There are four community hospitals in my own constituency—Bradford on Avon, Trowbridge, Warminster and Westbury. The quality that they and 400 like them provide is undisputed. The cost per case treated is capable of manipulation, but the best evidence that we have suggests that community hospitals are highly competitive. They are characterised by strong local support, local fundraising and of course by leagues of friends that have over the years provided the NHS with substantial subsidies.
	Community hospitals also have a dedicated work force—people who are expert in what they do and are pleased to serve at the less glamorous margin of our health care system, secure in the knowledge that their largely unsung work is contributing massively to the well-being of their community. Any large organisation must base itself around its skilled work force and Ministers must not assume that those wonderful people will relocate to the nearest district general hospital or shiny new independent sector treatment centre if their hospital is closed down. As community hospitals close, it is likely that many will simply be lost to the NHS altogether.
	Despite all the virtues of community hospitals, Ministers do not have a clue how many community hospitals there are, or where they are. I know that because I have asked them. Nor do Ministers know how many are under threat, so we have been forced to conduct our own research. It appears that more than 90 community hospitals are under threat and the figure could be higher. What is more—and this is the crucial point—there appears to be a strong correlation between PCT deficits and community hospital closures.
	Many of the PCTs in trouble serve small towns and villages, and we know from the Government's research that they are relatively underfunded. That puts to bed the notion that shutting community hospitals is all about improving health services. It is not: it is all about dealing with Government-inspired deficits, especially in parts of the country with which Ministers have little sympathy. However, care in community hospitals is as cheap as chips compared with similar treatment in a district general hospital. Closing them would surely cost more, as patients default to other providers.
	The trouble is that the same Secretary of State who is comfortable using her long screwdriver to micro-manage the NHS—as shown by her insistence last week that PCTs reinstate out-of-hours GP cover—told me when we met a few days ago that hospital closures are entirely a matter for local decision making. Other hon. Members tell me that they have had a similar response and that the Secretary of State is adept at interpreting the comments of local overview and scrutiny committees in a way that creates a pretence of local accountability. Faced with deficits that are largely not of their making, trust chief executives scratch around trying to square away their little bit of NHS budget as they are legally obliged to do, and naturally they light upon community hospitals. The cost of closure to the wider health care economy, including social services and acute units, let alone patients and carers, is of secondary importance and the person in overall command—I hope that the Secretary of State is listening—is unwilling to take charge.
	The Secretary of State was pleased to wave a copy of her party's election manifesto at me when we met the other day to discuss community hospitals, especially those in my constituency. The manifesto contains a clear and unambiguous commitment to community hospitals, but PCT deficits are closing them down. We are entitled to ask when the Secretary of State's action will match the rhetoric.

Jane Kennedy: Once again, we have had an Opposition day debate that has generated more heat than light from Opposition Members. The Government are taking the NHS forward to a better future, not condemning it to the failures of the past under the previous Government. The NHS is safe with the Government. Access to operations will remain based on need, not on ability to pay.
	The Opposition have form. Their 2005 manifesto was clear about what they really wanted to do with the NHS. They wanted to charge for operations. They wanted to make cuts and to take money from mainstream health services and give it as a subsidy to the rich few so that they could jump the queue. They said a lot about deficits during the debate—

Greg Hands: rose—

Jane Kennedy: I shall not give way to the hon. Gentleman because I have only a few minutes in which to respond.
	With the Government, there are guaranteed waiting times. Under the main Opposition party, there would be a return to unlimited waiting times. Members from Surrey and Sussex complained of longer waiting times. The House might like to learn that there were 8,900 patients in Surrey and Sussex waiting for out-patient appointments in 1998. At present, there are just 2,700. That is still too many and we acknowledge that we have more to do, but we are the Government who will deliver a total patient waiting time, from beginning to end, of 18 weeks. With this Government, queues are being cut. With that lot on the Opposition Benches, queues would be jumped but only by the rich few. Only the Government will safeguard an NHS that is fair to everyone and personal to each of us—[Interruption.] They really do not like it when the facts are put to them, but I shall give each Member who has spoken the facts about their strategic health authority so that the House can note exactly what is being done in terms of resources in their area.

Iris Robinson: rose—

Jane Kennedy: If the hon. Lady will forgive me, I really cannot give way as I am short of time. She has not been in the Chamber for the whole of the debate, and I want to deal with what has been said.
	Only the Labour Government will safeguard an NHS that is fair to everyone and personal to each of us, not as the Opposition want—timely health care but only for those who can afford it. It is true that the main Opposition party voted against our extra investment in the NHS—something that they resisted when it was mentioned by a number of my hon. Friends. In 2001, we made the case for a rise in national insurance contributions to pay for a better health service. The British people backed us because they wanted to put right the damage done by the Conservatives over 18 long, miserable years. The Conservatives opposed our extra investment, so they cannot now complain that the NHS is not improving as fast as they would like and expect to be taken seriously.
	If the NHS was once more in the hands of the Opposition, they would again make cuts rather than putting in extra investment for extra nurses, doctors and hospitals. Their record on health is one of failure. When they were in power they failed to invest in our national health service and neglected its progress.
	Since 2002 and by 2008, £1.2 billion extra will have been invested in the strategic health authority that covers the South Cambridgeshire constituency. That is paying for 5,934 extra nurses and 352 more doctors in training. The hon. Member for South Cambridgeshire (Mr. Lansley) might like to reflect on the fact that, when the Government came to office in 1997, there was a critical shortage of doctors and nurses because the Conservatives had cut training places for the future. Between 1979 and 1997, waiting lists increased by 400,000 and about 60,000 general and acute beds were cut.
	Don't you just love the Liberal Democrats—[Interruption.] Of course, I did not mean you, Mr. Deputy Speaker. We really must press the Liberal Democrats for some sensible policies. The main weakness of their position on health is that they never put forward anything other than a wish list of uncosted ideas without realistic timetables. But they have a secret agenda for breaking up the NHS. In "The Orange Book", leading Liberal Democrats such as the hon. Members for Yeovil (Mr. Laws), for Winchester (Mr.Oaten) and for Twickenham (Dr. Cable) advocated scrapping the NHS. They do not often speak about that, and the hon. Member for Romsey (Sandra Gidley) certainly did not refer to it, although she said that some things had got better. She should also acknowledge that the number of consultants in the strategic health authority area that covers her constituency has almost doubled and there are 428 more doctors in training. In March 1997, 4,638 people were waiting longer than nine months for in-patient appointments. How many are waiting for in-patient appointments at present? None at all. Not one.
	Liberal Democrats persistently face two ways. Their inconsistency is usually dependent on what they believe will buy them the most votes in a locality. For example, they campaign in their localities for foundation trust status, yet they turn their votes against such proposals in the House.
	My hon. Friend the Member for Crawley (Laura Moffatt), an acknowledged and fierce campaigner for her local community, noted the tremendous effort made by staff in her local hospital. I hope that she accepts that Crawley primary care trust will receive an increase of about 19.5 per cent. in its resources over the next two years, increasing to £129 million in 2006 and to £141 million in the following year. Far better to be working to recover deficits and improve efficiency and financial management under those circumstances than those that prevailed under the previous Government.
	The hon. Member for Eastbourne (Mr. Waterson) should really have a look at what his county council is doing. It would rather pay fines for bed blocking than sort out the problems locally. Resources for the Surrey and Sussex SHA will rise by a total of £1.4 billion.
	My hon. Friend the Member for Wirral, West (Stephen Hesford) gave an excellent speech—a robust demolition of Opposition arguments. They really do not like it when the case is put to them. My hon. Friend demonstrated the depth of his knowledge of his constituency and local health services. The Minister of State, my hon. Friend the Member for Doncaster, Central, will be pleased to learn that there are 400 more dentists in the SHA covering Wirral, West, as a result of the extra resources going to the health service. There are 400 more general medical practitioners and 600 more consultants. Opposition Members say that those extra resources are a waste of resources and a waste of time, yet all those extra nurses, doctors and dentists are bringing real and valuable improvements to services, which all our constituents are experiencing.
	I am rapidly running out of time. When I listened to the speech of the hon. Member for Sutton and Cheam (Mr. Burstow), I was confused about the galloping horses and bolting doors. Some Opposition Members made bizarre contributions.
	It is not true to say that the Government are not interested in community hospitals. The new generation of community hospitals will deliver integrated care in a single location that will facilitate multidisciplinary teamwork, which will produce even greater improvements in the services that our constituents receive.
	As we said at the outset, the NHS is in receipt of record resources as a result of the Government's policy on NHS funding. With that level of investment, all NHS bodies should be able to plan for and achieve financial balance every year. Indeed, the majority of NHS organisations are delivering service improvements and living within their budgets.
	I give credit to the hon. Member for Westbury (Dr. Murrison). He is just about the only Conservative Member who paid tribute to the staff who are delivering the improvements. Those staff deserve our sincere gratitude and support. They will get that from the Government.

Question put, That the original words stand part of the Question:—
	The House divided: Ayes 231, Noes 312.

Question accordingly negatived.
	Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to
	Mr. Deputy Speaker forthwith declared the main Question, as amended, to be agreed to.
	Resolved,
	That this House welcomes the Government's record levels of investment in the National Health Service, with expenditure set to rise to over £92 billion by 2007–08; notes that by this date £70 billion, more than ever before, will be going to the NHS front line; congratulates the Government on delivering investment and reform, leading to historic improvements to NHS services and capacity, reducing waiting times to their lowest in nearly a generation, from over two years to a maximum of six months, and to a maximum of 18 weeks by 2008, employing nearly a quarter of a million more NHS staff than in 1997, including 78,700 more nurses and 27,400 more doctors, and undertaking the largest hospital building programme in the history of the NHS, including investing £100 million in a community hospitals programme; further notes that the NHS has achieved overall financial balance in each of the past four years, and last year carried a deficit of around only 0.4 per cent. of total resources; compares this with the record of the previous Government which left the NHS with a £460 million deficit in 1996–97 which amounted to almost 1.5 per cent. of total resources; and agrees that, given the record increases in health funding available coupled with the strengthening of Primary Care Trust commissioning, all NHS organisations should be able to live within the resources available to them and to provide excellent services to their populations.

LICENSING ACT 2003 (S.I. 2005, NO. 2091)

Motion made, and Question put,
	That an humble Address be presented to Her Majesty, praying that the Licensing Act 2003 (Second appointed day) Order 2005 (S.I. 2005, No. 2091), dated 27th July 2005, a copy of which waslaid before this House on 29th July, be annulled. —[David Maclean.]
	The House divided: Ayes 228, Noes 302.

Question accordingly negatived.

Ministerial Code

Mr. Deputy Speaker: We now come to the debate on oversight of the ministerial code. I must tell the House that Mr. Speaker has selected the amendment in the name of the Prime Minister.

Chris Grayling: I beg to move,
	That this House notes the recommendation made by the Committee on Standards in Public Life that there should be an independent Adviser on Ministerial Interests; and insists that the Government should immediately begin the process of establishing such a position.
	Let me start by saying that it is always a pleasure to debate with the Minister, but I am sure that even he would agree that it is nothing short of astonishing that we still do not have a Chancellor of the Duchy of Lancaster to lead for the Government in tonight's debate three weeks after that vacancy was created. It is no sign of the Prime Minister's confidence in the importance of the Cabinet Office.
	This debate follows a number of recent controversies, including the resignation of the former Secretary of State for Work and Pensions, creating the vacancy to which I referred. However, the purpose of tonight's motion is not to rake over the coals of that resignation—that would be wrong and inappropriate. The events of the past few weeks have raised important issues about the oversight of the ministerial code and, in particular, have reinforced criticisms made by Sir Alistair Graham, who chairs the Committee on Standards in Public Life. The Government have ignored those issues for too long, but in the wake of the resignation of the right hon. Member for Sheffield, Brightside (Mr. Blunkett) they can no longer be allowed to do so.
	My hope is that the Government will not seek to oppose the motion, but that they will instead accept its inevitability. In the Government's amendment, they claim that they will make an announcement on these matters "shortly". We have been waiting for that announcement for the past two years, much to the fury of those involved in putting together the original recommendation by the Committee on Standards in Public Life. Frankly, shortly is not good enough.
	The Government have always made the right noises over standards in public life. They have introduced a stronger ministerial code and made tough noises about keeping to it. In the introduction to the code, the Prime Minister is unequivocal about its importance:
	"In issuing this Code, I should like to confirm my strong personal commitment to the bond of trust between the British people and their Government. We are all here to serve and we must serve honestly and in the interests of those who gave us our positions of trust."
	Those are fine-sounding words, but on many occasions they have proved to be just that—words and not a yardstick by which all ministerial action is judged. Fine words, little action.
	I want to give the House some other wise words that were passed to me by one my constituents on the day after the resignation of the Secretary of State for Work and Pensions. The words come from one of the House's most distinguished and much missed figures. My constituent said:
	"I may have told Chris the story of how I decided to go to the Scott enquiry one day, was told I had to get into the queue by 8 if I wanted to be sure of getting in at 10, and found myself to my surprise next to Robin Cook. At one stage I asked him whether the Matrix Churchill business was just a one-off with particular people being in particular places at the same time or whether it was something endemic in the British system of government. He gave what I thought was an excellent answer—No, it wasn't either of those—it was more that when one party had been in power for a long time Ministers become progressively less able to distinguish between the public interest, their party interest and their private interests."
	Those words were spoken in a very different period of government, but they ring true today. Ministers, from the Prime Minister down, seem to have forgotten the things that they said in opposition and the commitments that they made when they came to power. Either that, or they just do not think that the rules apply to them.
	The origins of the motion lie in the work done two years ago by the Committee on Standards in Public Life, now chaired by Sir Alistair Graham, but then chaired by Sir Nigel Wicks. Government Members will remember the establishment of the committee in the mid-1990s, after the last Conservative Government found themselves under pressure about standards from the right hon. Member for Sedgefield (Mr. Blair), who was then Leader of the Opposition. The then Prime Minister described the committee as a welcome response to "public anger" and claimed that
	"the warning signs over these issues have been ignored for much too long."
	Tonight, my charge against the Prime Minister is that he is guilty of the very offence of which he accused his Conservative predecessors. The warning signs have been present for much too long, and he continues to ignore them.
	Not one but two Cabinet Ministers have resigned twice from the Government. One of them, the European Commissioner Peter Mandelson, even appears to have been guilty of a third offence of not declaring a position that he accepted with the Advisory Committee on Ministerial Appointments. If he were still a member of the Government he would now be in danger of an unprecedented hat-trick of resignations. Unbelievably, he said:
	"Why cannot ex-Ministers face the same requirements concerning their business appointments as civil servants?"—[Official Report, 2 November 1995; Vol. 265, c. 479.]
	Mr. Mandelson went on to ignore those very requirements when he left office.
	Other examples have been in circulation in recent weeks. One Cabinet member apparently rushed to lodge a declaration of interests with the permanent secretary under the ministerial code only when a newspaper started to ask difficult questions. I sometimes wonder whether Ministers think that they enjoy some kind of moral superiority and that the rules do not apply to them. In fact they do, and it is time that there was proper independent scrutiny to stop them ignoring their responsibilities in an often cavalier way.
	Two years ago, the Committee on Standards in Public Life completed its ninth report. It is, as always, a comprehensive and detailed work that looks at a wide range of issues that affect the governance of our country. A key part of its work that year was to look at the detailed workings of the ministerial code. In particular, it set out two key recommendations, one of which is central to tonight's motion. I hope that the Government will give the other recommendation due consideration in the light of recent events.
	Let me set out for the House the recommendation that I will ask Members to support at the end of our debate. The committee called for an independent office-holder—called an adviser on ministerial interests, to be established to provide advice to Ministers on compliance with those sections of the ministerial code that cover the avoidance of perceived and actual conflicts between their public duties and private interests, formal or otherwise. The committee went on to say:
	"The Ministerial Code should be amended to require an incoming Minister to provide the Adviser . . . with a full list in writing of all interests which might be thought to give rise to a conflict . . . the Adviser should consult the Minister's Permanent Secretary about departmental business where necessary to enable the Adviser to ascertain whether a conflict of interest may exist . . . The Adviser should be responsible for maintaining a record of ministerial interests and should keep a note of action taken by a Minister on taking up office . . . The Adviser should publish information and guidance on how Ministers should deal with conflicts of interest . . . Where unforeseen conflicts arise subsequently during the course of a department's work, the Minister should consult the Adviser."
	Finally, the Committee said:
	"The Adviser should refer any breach or allegation of a breach to the Prime Minister."
	That seems to be an eminently sensible set of recommendations. At present, the system requires Ministers to refer their interests to their permanent secretaries, and any breaches are a matter for the Prime Minister.
	That system is clearly flawed. Government Ministers, particularly Cabinet Ministers, are required to work on a daily basis with their permanent secretaries, so a close personal working relationship is established. It is entirely wrong to ask permanent secretaries to serve as the referee for the financial and other dealings of Ministers, as that risks compromising that day-to-day working relationship. That was certainly the view of Sir Nigel Wicks and his committee in the report:
	"Permanent Secretaries should have no responsibility for giving advice to Ministers on conflicts of interest arising under the Ministerial Code."
	The role of the Prime Minister as both poacher and gamekeeper is one that should be questioned, and I will return to that in a moment. The system places the Cabinet Secretary in an extremely difficult position. Two weeks ago, both the right hon. Member for Sheffield, Brightside and I wrote to the Cabinet Secretary about his breach of the ministerial code, which he failed to consult before taking appointments outside Government after leaving ministerial office. The Cabinet Secretary replied to both of us. In his reply to the right hon. Gentleman, he said that he believed that there had been a breach of the ministerial code. In his response to me, however, he made it quite clear that that was not a matter for him. I do not blame him for that, but there is a confusing situation, which is not tenable.
	One of the people who contributed to the work of the Committee on Standards in Public Life two years ago was Peter Preston, former editor of The Guardian. His view was typical of many people involved in producing the report:
	"I said to an earlier meeting of this Committee some years ago that I thought it was completely wrong that Cabinet Secretaries should be wheeled on, as sort of ad hoc men of probity, when there was a question under the Ministerial Code . . . If the supreme code, the Ministerial Code, now much embellished under this government, does not have an independent element in investigating and deciding what happens under it, everything else becomes bendy and much less satisfactory than it should be."
	I hope that our debate tonight will mark the start of a process that will redress that situation. Furthermore, the motion before the House seeks, in substantial measure, to follow a path already accepted by the Government two years ago. That is why I dispute the Government amendment. Two years ago, the Government accepted many of the principles behind our motion, but they have done nothing since. That is why we do not accept the platitudes in the Government amendment. Why cannot the Minister accept the Opposition motion or at least give the House a straightforward timetable for their plans? The word "shortly" is simply too vague for us to accept.

Tony Wright: The hon. Gentleman is confusing two separate recommendations. There was a recommendation to establish an adviser on interests, which is not a sensible suggestion, as I hope I have a chance to explain later. There was also a recommendation to establish an independent investigator of complaints, which is a sensible suggestion. Unfortunately, however, the Opposition have pursued the silly proposition and ignored the sensible one.

Chris Grayling: The hon. Gentleman is right that there are two recommendations and I intend to deal with both of them. Our motion is designed to put in place an independent adviser on ministerial interests, and I hope that the hon. Gentleman will accept my explanation of whythat is the first step. I believe that both recommendations are desirable, but in tabling the motion I hoped that the Government would accept the first one, although I fear that I will be disappointed.
	The Government did not agree with all the committee's recommendations on the ministerial code. They did not like all the proposals for an independent adviser and they wanted to leave permanent secretaries as the focal point for discussions about the code. However, as the Minister will know, they accepted that it would be sensible to have an independent adviser from whom additional advice could be sought by both Ministers and permanent secretaries. At the very least, that would provide a second opinion for Ministers in difficult situations. Nothing, however, has happened. The chairman of the Committee, Sir Alistair Graham, has expressed anger about that and went public with criticisms of the Government this summer. I asked him if his Committee would make recommendations about the role of prime ministerial spouses, the rules that apply to them and the support provided for them after public concerns were expressed about the commercial activities of the Prime Minister's wife. Sir Alistair gave me a direct response. He stated:
	"The Ministerial Code, as revised and published on the day before the Recess, makes it clear that proper consideration of Ministers' private interests include the private interests of a spouse or partner (paras 5.1–5.3]. In its Ninth Report . . .the Committee made a detailed proposal . . . for the creation of an Adviser on Ministerial Interests whose advice and guidance might have been useful in the circumstances you drew our attention to. Unfortunately, while the Government in its Response (Cm 5964, September 2003) accepted the case for appointing an independent adviser (Ibid, pp. 2–3) no action has been taken."
	That is not from me or from a member of the Conservative party, but from the independent chairman of the Committee on Standards in Public Life.
	That was not the only time during the summer that Sir Alistair had cause to criticise the Government. In July, he expressed great unhappiness at the way in which the Government had dealt with the issue of the code of conduct for special advisers. He expressed
	"dismay at the way the Government had changed the legislation governing the role of Special Advisers without proper parliamentary or public debate"
	and stated:
	"I am naturally disappointed that the concerns my Committee raised about the revisions to the Code of Conduct have not been taken into account."
	What is the point of an independent committee to monitor standards in public life if the Government of the day do not listen to what it says? Is it not the height of arrogance for Ministers who railed about public standards when they were in opposition to act as though the independent mechanisms that they demanded then do not have to be listened to now that they are in office themselves?
	The other central issue in the debate tonight is the role of the Prime Minister as ultimate arbiter of the ministerial code. That surely cannot satisfactorily remain in place in the future. We have seen in the past few weeks issues about the ministerial code raised over the activities of one of his closest friends and allies in the Cabinet. There is no doubt that the loss of the right hon. Member for Sheffield, Brightside was a major blow to the Prime Minister at a time when things are just a little heated within his party, yet it fell to the Prime Minister to be the judge of the rights and wrongs of the situation.
	In the past few months legitimate questions have also been raised about the commercial activities of the Prime Minister's wife and how they relate to the ministerial code. In these two cases, involving a close colleague of the Prime Minister who can provide advice to him, and the Prime Minister's wife, which raises questions about who she turns to for advice, how can the Prime Minister possibly fulfil the role of ultimate arbiter of the ministerial code?
	When the issue of the Government's support for the businessman Lakshmi Mittal arose, criticisms were directed at the Prime Minister and questions were asked about his conduct. Yet on questions about the Prime Minister's action and guidance to the Prime Minister, the ultimate referee was the Prime Minister himself. That cannot be the proper way of handling standards issues in a modern democracy.
	The question has also been raised about the ability of any Prime Minister to serve as overseer or arbiter of the code, given all the other pressures on him or her. During the last few hours in office of the right hon. Member for Sheffield, Brightside, the Prime Minister at one point openly admitted that, owing to pressure of work, he was not fully up to date with what was going on. Of course he cannot be. The Prime Minister of the day cannot be expected to fulfil that role and to have the time to study everything that is going on.
	That is why I hope the Minister will give an indication tonight that the Government will consider the creation of the other element of the recommendations to which the hon. Member for Cannock Chase (Dr. Wright) referred a moment ago—not simply an independent adviser, but an independent investigatory process for people who are alleged to have transgressed in relation to the ministerial code, and where there are doubts whether the ministerial code has been fulfilled.
	The Committee recommended that
	"At the beginning of each Parliament, the Prime Minister should nominate two or three individuals of senior standing after consultation with leaders of the major opposition parties.
	(b) The names of these individuals should be made public.
	(c) Should the Prime Minister consider an investigation into an allegation of a breach of the Ministerial Code appropriate, the Prime Minister would invite one of these individuals to conduct that investigation.
	(d) The individual selected to carry out an investigation should investigate the facts and report his or her findings to the Prime Minister, who would decide on the consequences for a Minister. The report should be published."

Tony Wright: For the sake of accuracy, perhaps I can help the hon. Gentleman a little further. The problem is that the sixth report of the Committee on Standards in Public Life stated with great authority that there should not be any independent investigator. Three years later, the ninth report stated that there should be. Ultimately, we cannot call in aid such external bodies. We have to decide for ourselves about these things.

Chris Grayling: Perhaps the Committee was taken in by the protestations of purity that the Government articulated when they first took office, found itself disappointed some years later and realised that it needed tougher action after all. At the very least, the House must surely agree that it is odd that Members of Parliament can be referred to our own Parliamentary Commissioner for Standards or the Committee on Standards and Privileges, but that there is no point of reference for potential breaches of the ministerial code. Does the Minister consider the situation satisfactory?

Fraser Kemp: If the hon. Gentleman's proposition is successful, will he urge the independent adviser to take on board a report from the Committee on Standards in Public Life, which pointed out that for Opposition spokesmen there was "no specific requirement" that they divest themselves of financial interests along the lines of the ministerial code? However, Lord Neill of Bladen went on to say that they are able to exercise influence over parliamentary matters and over the wider political debate in their capacity as spokesmen and women, and that that warrants investigation. Will the hon. Gentleman urge his independent adviser to take on board the comments of the Committee on Standards in Public Life, in order that we can avoid any sense of impropriety when Opposition Front-Bench spokesmen and women receive funds from companies and organisations which cover their sphere of influence on the Opposition Front Bench?

Chris Grayling: I know that you will not allow me to stray too far from the motion, Mr. Deputy Speaker. I look forward to having the chance as a Minister after the next general election to conform closely to the terms of the ministerial code.
	It is not often that Opposition Members quote from the diary of Piers Morgan, the former editor of the Daily Mirror, but let me tell the House about the entry for Thursday 27 March 1997, a month before the general election that brought the Government to power. It mentions an interview with Tony Blair.
	"'I won't be weak on sleaze like the Tories," he said. "We have got to be whiter than white if we are to rebuild trust in government.'"
	What was Morgan's prediction?
	"I reckon that might just come back to haunt him."
	I think that it has.
	The Prime Minister told us:
	"I'm a regular kind of guy"—
	after accepting a multimillion pound donation and then changing his policy to help the donor. He defended the former Minister for Europe before he resigned, saying he thought he had done nothing wrong. He defended Peter Mandelson before he resigned, and resigned again, saying he did not think he had done anything wrong. Two weeks ago he defended the right hon. Member for Sheffield, Brightside before he resigned, and then said that he left office without a stain on his character.
	Surely the Government must realise that it is not tenable for the Prime Minister to be the ultimate arbiter of ministerial standards, and that the time has come to bring an independent element into the process of monitoring and advising on the way in which Ministers treat the code. There is no point in having an independent committee to advise on standards in public life if we do not listen to what it says. The Prime Minister and his colleagues argued for it when they were in opposition, when they were challenging the Conservative party over issues of standards. Now that they are in government, they find it much less convenient to pay attention, and much less convenient to do what is right. In my book, that is not upholding standards—it is nothing less than double standards, and it is not good enough.
	Let me conclude by taking Labour Members back to the days when their party was in opposition, and in particular to the words of the Prime Minister on the night that the Commons debated the first report by the   Committee on Standards in Public Life, under the chairmanship of Lord Nolan. That night the then Government did not agree with everything Lord Nolan wanted and they faced an onslaught from an outraged Opposition, led by the current Prime Minister, who demanded of the then Prime Minister:
	"Just what do he and his party have to hide?"
	He went on:
	"If now, in weakness, the Prime Minister goes back on his word to implement the report that he commissioned, it will leave a stain on his prime ministership and on his Government that will not be removed until this rotten Administration is swept from office."—[Official Report, 2 November 1995;Vol. 265, c. 387]
	A decade on from that night, that same Leader of the Opposition is now the Prime Minister and he has performed a complete about-turn. Now he does not want to implement a report on standards that he commissioned. Tonight, my question to him and to the Minister is the same question as he once asked: just what do he and his party have to hide?

Jim Murphy: I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
	"acknowledges that, amongst other measures, this Government introduced a requirement for individual Ministers, on appointment to each new office, to provide their Permanent Secretary with a full list in writing of all interests which might be thought to give rise to a conflict; welcomes the section of the Ministerial Code on handling Ministers' private interests which is more comprehensive than Questions of Procedure for Ministers; and recognises that this Government has agreed to appoint an independent adviser to provide Permanent Secretaries and Ministers with an additional source of professional advice as required and will make an announcement on this shortly.".
	The hon. Member for Epsom and Ewell (Chris Grayling) began by saying that he would not rake over recent events, before he raked over every recent insinuation. The good thing about debating with him is that he always gives notice in a rather polite way of the points that he is about to make through the pages of the Daily Mail. He is often tempted to behave like a Daily Mail copywriter, and he always succumbs to that temptation.
	It is important to put the debate about standards, openness and the ministerial code in context. We have always made it clear that the public should expect the highest standards of propriety in public life, and this Government have introduced transparency, which did not exist under previous Conservative Administrations. That transparency relates to Ministers, special advisers, Parliament and the public.
	We were the first to publish a ministerial code and the annual list of gifts to Ministers, which was strongly opposed by the previous Government, for whatever reason.

Oliver Heald: Before the Minister gets carried away, the ministerial code has been published since 1992.

Jim Murphy: No, it has not. The ministerial code was first published in 1997, and the hon. Gentleman will have an opportunity to discuss that matter. [Interruption.] He is contradicting his own intervention from a sedentary position. What was published in 1992 was not a ministerial code—it was called something entirely different—and it was reformed, reviewed and extended to make it much more powerful. He is making the winding-up speech for the Opposition, so he should not contradict his own intervention.
	We were the first to publish a ministerial code and a list of gifts worth more than £140 that are given to Ministers, and we were also the first to publish a code of conduct for special advisers and the number, cost and names of special advisers, none of which happened before. On openness in Parliament, the Prime Minister was the first to appear before the all-party Liaison Committee, which was previously unheard of, and opportunities for pre-legislative scrutiny have also increased.
	On public openness, we have the long-campaigned-for Freedom of Information Act 2000, which was long opposed by other parties.

David Heath: Party.

Jim Murphy: With due respect to the smaller parties, the 2000 Act was opposed by the main Opposition party. Through the Political Parties, Elections and Referendums Act 2000, we reformed donations from overseas donors.
	The Public Administration Committee acknowledged those developments in its report, "The Ministerial Code: Improving the Rulebook":
	"The Government have put in hand important constitutional changes with positive implications for enhanced accountability."
	That contrasts with what happened before, when there was, at best, intransigence on those issues about public life.

Peter Bone: As a new Member of Parliament, I was surprised to discover the lack of independent scrutiny of the ministerial code. Does the Minister agree that local borough and district councillors are subject to greater independent scrutiny than Ministers?

Jim Murphy: No. Ministers are accountable to this place, to the Prime Minister and in all sorts of other ways. Accountability has improved in recent years, and people recognise that improvement.
	Before Conservative Members start to think that the ministerial code is a development for which they can take credit, I should point out that a template for questions of procedures for Ministers was originally drafted in 1917 by the first secretary to the Cabinet, Sir   Maurice Hankey. Directives on procedures for Cabinet government issued by the Prime Minister during the second world war were drawn up into a single document by a gentleman called Clement Attlee and issued to all incoming Ministers in 1945 on a confidential basis.

Philip Hollobone: The Minister has said that the Government have made the ministerial code more transparent. Paragraph 1.3 of the code states:
	"The Code is not a rulebook".
	In the foreword to the code, the Prime Minister states:
	"I will expect all Ministers to work within the letter and spirit of the Code."
	When the former Secretary of State for Work and Pensions, the right hon. Member for Sheffield, Brightside (Mr. Blunkett), resigned, the Prime Minister told this House that he thought that the former Secretary of State had done nothing wrong. How do those three things make a more transparent process?

Jim Murphy: I will come on to some important aspects of the ministerial code later, but I shall deal with the case of the former Secretary of State for Work and Pensions now. My right hon. Friend made a mistake—a technical breach of the ministerial code—and resigned. He paid a heavy price, which is in stark contrast to significant numbers of Conservative Members being paid to ask questions in this House. Not one, but two former Conservative Ministers ended up in prison for their actions, and another Minister from that time had to resign because of detailed allegations about how he sought to block investigations into the cash for questions affair. Yes, my right hon. Friend has paid a heavy price. He made a mistake, but it involved breaching the ministerial code on a technicality, which is a world away from events under previous Conservative Administrations.

Chris Grayling: rose—

Jim Murphy: The hon. Gentleman spoke for a substantial time, and I want to make some progress before I give way.
	In contrast to what went before, the ministerial code is updated and published after each general election, so the most recent version was published in July 2005. The ministerial code provides guidance to Ministers on how they should act and arrange their affairs in order to uphold the highest standards of constitutional and personal conduct in the performance of their duties.
	The new ministerial code takes into account a recommendation from the Committee on Standards in Public Life and is split into two parts—a ministerial code of ethics and procedural guidance for Ministers. Ministers are personally responsible for deciding how to act and conduct themselves in the light of the code and for justifying their actions and conduct in Parliament. The Prime Minister is the ultimate judge of the standards of behaviour expected of a Minister and of the appropriate consequences of a breach of standards. Given the wide range of topics covered by the ministerial code—they range from appointments made by Ministers to arrangements for contacting diplomatic posts overseas in relation to ministerial travel plans—the Prime Minister should not be expected to comment on every allegation, although Conservative Members expect him to. As the Public Administration Committee said in its report, "The Ministerial Code: Improving the Rulebook":
	"It is not possible for a Ministerial Code to cover all possible cases and circumstances. Nor should that be its purpose. It should identify the basic ethical principles of Ministerial conduct".
	Turning to the specific point raised by the hon. Member for Epsom and Ewell about the independent investigation of alleged breaches, as my hon. Friend the Member for Cannock Chase (Dr. Wright), who chairs the Public Administration Committee, has said, the Committee on Standards in Public Life considered the merits of the appointment of an independent investigator in its sixth report in 2000. The Committee concluded that it would be
	"undesirable to make a recommendation that would fetter the Prime Minister's freedom",
	and it went on to recommend that
	"No new office for the investigation of allegations of ministerial misconduct should be established."
	The Committee reversed its position in its ninth report, but the arguments that it advanced in its earlier report are still valid. We have not changed our minds on that.
	This proposal involves a point of principle and a point of practicality. It strikes at the principle of democratic accountability and the way in which the Government are run. The electorate decide who is in power and the Prime Minister decides who serves in his or her Government. My right hon. Friend the Prime Minister made the position clear in his press conference on 7 November when he said:
	"The only person who decides who is in the Government or not in the end is the Prime Minister. You can't subcontract that decision. That is why I didn't agree with the recommendation and still don't."

David Jones: It is true that it is not possible to subcontract that function, but is it not possible to subcontract the investigation process prior to the Prime Minister making whatever decision he makes about the position of an individual Minister?

Jim Murphy: That brings me to the question of practicality. The Government do not believe that it is practical to identify, in the way in which the hon. Member for Epsom and Ewell and others have suggested, an individual or group of individuals who can be appointed on a standing basis to investigate any or all inquiries that are recommended through Members of Parliament bringing a matter to their attention or—an almost weekly occurrence—through the pages of the press.

Chris Grayling: But is not that exactly what happened in the case of the first investigation into the right hon. Member for Sheffield, Brightside, which led to his first resignation? Sir Alan Budd was called in to carry out that inquiry. What is the difference?

Jim Murphy: The important difference is that the Prime Minister reserves the right to decide who is in Government, to decide when an inquiry is necessary, and to appoint an independent person if required. Sir Alan Budd did indeed carry out that inquiry. As an eminent individual and a member of the Monetary Policy Committee, he was the appropriate person called in by the Prime Minister. However, there is a strong belief that it is entirely impractical to appoint on a standing basis someone like Sir Alan Budd—Sir Anthony Hammond, for example, who carried out another investigation at the Prime Minister's request—and perhaps one or two other individuals. We expect to get people of good standing with great experience and high personal morality. Practically speaking, it is very difficult to require them to give a commitment to investigate what may initially be one case, but will subsequently lead to others as a consequence of allegations that may be well founded or may be based on media tittle-tattle.

Gordon Banks: Members on both sides of the House have mentioned not only ministerial codes of conduct but standards in public life in general. The Minister referred to what we see in the pages of the press. On what basis did the Cabinet Office approve the memoirs of Sir Christopher Meyer, which have been serialised in one of our daily papers?

Jim Murphy: The debate on standards in public life is very wide ranging. There have been written questions about the matter that my hon. Friend raises, so I have of course been briefed about it. The fact is that the Cabinet Office did not clear such a book—

Mr. Deputy Speaker: Order. It may help the Minister to know that as the debate is confined to the ministerial code he need not deal with that point.

Jim Murphy: Thank you, Mr. Deputy Speaker. In the light of your strictures, I undertake to place a record of what the Government and the Cabinet Office did in that respect in the Library so that everyone—Members of both Houses of Parliament and the media—can have access to it.

David Heath: I am grateful to the Minister—I hope that it makes as entertaining reading as the excerpts.
	The Minister said that it would be impossible for a person of appropriate standing to carry out this role on a permanent basis. He needs to be careful in his choice of words not to undermine the positions of the Parliamentary Commissioner for Standards or the chairman of the Committee on Standards in Public Life, both of whom have standing positions as well as, in the view of most of us, extremely high standing.

Jim Murphy: Nothing could be further from my mind than questioning the integrity and professionalism of those individuals. The Government and the Prime Minister have made it clear that we do not rule out the possibility of asking individuals outside the Government to conduct an investigation into allegations of ministerial misconduct. We have been judged on our actions and, when necessary, external inquiries have taken place.
	For example, in 2001, Sir Anthony Hammond QC was asked to conduct an inquiry into the circumstances surrounding the naturalisation of Mr. Hinduja. Of course, Sir Anthony Hammond is standing counsel to the General Synod of the Church of England and, as I said, Sir Alan Budd, who was a member of the Monetary Policy Committee from 1997 to 1999, undertook another inquiry in 2004. We have the flexibility to enable external investigation of serious allegations to take place when the Prime Minister believes that it is merited. That method has been tried and tested.

John Hayes: I am reluctant to criticise the Parliamentary Secretary, who is a good man with a promising career ahead. I say that in the spirit of the helpful motion tabled by the responsible and measured Opposition, who are trying to help Parliament and the Government to get through the mess. However, there is an element of complacency about the Parliamentary Secretary's response so far. Surely he recognises that there is confusion about the code, doubts about the lines of accountability, genuine uncertainty about the Prime Minister's role and a Committee on Standards in Public Life whose advice is not taken seriously. He should not be complacent. We must move on from the current position. What about the improvements that could be made? We need to hear a little more in that spirit.

Jim Murphy: I thank the hon. Gentleman for his compliment and take it in the spirit it was offered. However, he will single-handedly ensure that the future that he predicted does not happen if he persists with such compliments. I know that he is a good and honourable person and I assure him that there is no complacency. The Government continue to consider ways in which to improve standards in public life. They have done so since 1997 and continue that drive.
	As I said, we were the first Government to introduce a ministerial code, the Freedom of Information Act 2000, cleaning up party political donations, pre-legislative scrutiny, the Prime Minister's attendance at the Liaison Committee and many other things that simply did not happen under the previous Administration, despite the well catalogued failings of standards in public life. Belmarsh almost began its own Conservative Association as increasing numbers of former Conservative Ministers went there.

Angela Browning: The Parliamentary Secretary claims that Ministers are not complacent. Will he please tell us what the seven principles of public life are?

Jim Murphy: I shall write to the hon. Lady. Time does not permit me to go through all seven. [Interruption.] She holds up a copy of the ministerial code—I am sorry to say that I cannot read it from here.
	Our approach to such matters is in stark contrast to the evidence that Sir John Major presented to the Public Administration Committee. He said that, when breaches of the ministerial code were alleged, he
	"preferred to leave a large glass of brandy and a pistol in a darkened room for the Minister to make up their mind."
	We do not operate in that way.
	The Government made it clear in our response to the ninth report of the Committee on Standards in Public Life and the recommendation for an independent adviser on ministerial interests that permanent secretaries are best placed to understand Departments' work and advise Ministers on handling potential conflicts of interest. We have agreed to appoint an independent adviser on ministerial interests to provide private advice to Ministers and permanent secretaries, especially about more complicated cases. That will be in addition to the wide range of advice that is already available. Whoever is appointed to that office will need to understand how government and Parliament work and have the necessary expertise. As the amendment states, we will make an announcement on the matter shortly.
	However, I emphasise that the Government continue to believe that permanent secretaries are best placed to understand Departments' work and advise Ministers on handling potential conflicts of interest. No external adviser could be expected to match permanent secretaries' understanding in terms of knowledge of their Departments and the potential for conflict.

Peter Bone: The Parliamentary Secretary said that the former Secretary of State for Work and Pensions committed a technical breach of the code and that that was why he resigned. If there was clarity in the code and an independent adviser was helping, such a breach would not have occurred. Surely the fact that he had to resign shows that the system is not working.

Jim Murphy: There is no evidence whatsoever that what happened with my right hon. Friend the Member for Sheffield, Brightside could have been avoided by the availability of such an independent adviser. I say that that was a technical breach because that is what it was. It did not involve sneaking into a dark corner and asking for thousands of pounds to speak in the Chamber, or going into a court of law and committing perjury, or trying to block investigations into financial sleaze in the Government. It was a technical breach.

Chris Grayling: I cannot let the Minister get away with that. It is not my intention to spend too much time raking over the coals, but he must accept that the former Secretary of State for Work and Pensions has since admitted making telephone calls to investment bankers while he was a Cabinet Minister. In my view, that is not a technical breach of the code but one of the most serious breaches in recent years.

Jim Murphy: The former Secretary of State for Work and Pensions was in technical breach of the code. That is the reality of the situation. The hon. Member for Epsom and Ewell might wish to issue a press release to the Daily Mail, but if he wishes to enter into correspondence with me about this, I shall be happy to respond. On the Conservatives' wider agenda on this matter—in terms of the drip, drip, drip of press releases and so on—they seem unable to persuade anyone that the previous Conservative Government were not a national sleaze-fest, or that they have now reformed and deserve a second chance, or that an apology would be believed. My personal view is that some prominent members of the Opposition—by no means all of them—have therefore adopted a strategy of planting the seed of the idea that the other parties are just as bad as they are and, given the opportunity, would behave just as they did. Well, that will not work, because it is not true.
	The technical breach by the former Secretary of State for Work and Pensions was just that. It was not a deliberate attempt to commit the kind of criminal or fraudulent acts that were committed in a small number of cases over previous years. The Conservatives' strategy of suggesting that we are all the same reflects badly on all of us, and, it will not work. The public know which party was shrouded in the kind of sleaze that became endemic in the Conservative Government during the 1990s—[Interruption.] The hon. Member for Epsom and Ewell says from a sedentary position that the Conservatives won the last sleaze poll. Well, the poll that mattered was the general election, and that is why he is sitting on the Opposition Benches and we are sitting here. The public have made their decision on a whole variety of matters. However, we should get back to the debate that we are meant to be having, rather than continuing this interesting chat that the hon. Gentleman and I are having across the Dispatch Box.
	The Government have already done much to strengthen the ministerial code, as I said earlier. All Ministers are now required, on appointment to each new office, to provide their permanent secretary with a full list in writing of all their interests that could give rise to conflict. There is also detailed guidance on options for Ministers who may need to dispose of an interest or take steps to do so. Ministers are required to consult their permanent secretary on all these matters. There is also provision in the ministerial code for Ministers, when necessary, to obtain expert or professional advice from inside or outside Government.
	The hon. Member for Epsom and Ewell mentioned the Committee on Standards in Public Life. Even a cursory glance at the recent history of Government responses to the independent regulators of our body politic shows a whole series of recommendations by those charged with responsibility for keeping us on our toes, in terms of ethics and standards. The previous Conservative Government entirely flouted those recommendations and responded to them in a very negative way. For example, on the Treasury and Civil Service Committee's proposal for guidelines for Ministers, the Tory response was that it was not necessary. The ministerial code now contains those provisions. On a proposal on ministerial accountability, the Tory response was: "It is impossible." Aspects of the ministerial code now contain such provisions. On the Public Services Committee report of 1996–97 on ministerial standards, the Tory response summoned up the ability to "note the conclusions". Those recommendations are now covered by the ministerial code.
	The fact is that there was an ailment in our body politic, and there is still a degree of cynicism towards politics and politicians across the world. It does no good, however, for the Conservatives to adopt this strategy of suggesting that we are all in it for ourselves. The hon. Member for Epsom and Ewell said that the Labour party had forgotten what we said in opposition. This evening, it is as if he has forgotten what his party did in government. He sought election to this place in 1997 at the height of all those difficulties. I half expected him to wield the sword of truth and the trusty shield of fair play this evening, but I am glad that he kept that well sheathed.
	I want to thank the Conservative party, which has performed a great service to ethics in British politics. I know that many Conservative Members were not involved in what happened in the 1990s.

Fraser Kemp: On the question of Conservative ethics, the hon. Member for Epsom and Ewell (Chris Grayling) was uncharacteristically reticent when I raised the recommendation from the noble Lord Neill that there should be an investigation into whether the ministerial code should apply to Opposition Members. Will the Minister at least consider those recommendations to avoid impropriety on either side—not to engage in party political point scoring—and to make sure that the probity of the House, Ministers and shadow Ministers is always maintained?

Jim Murphy: My hon. Friend's suggestion is reasonable and fair. I would be interested to hear whether the Conservatives find that approach attractive, as it would be much easier to do that on a bipartisan basis, and the Conservative wind-up should offer a detailed response on that.
	The hon. Member for Epsom and Ewell referred to control over special advisers and their work, which is a regular theme for him, but he ignores the fact that we introduced a contract, oversaw the numbers and published those details, which had never happened previously.
	Another substantial area of public investment in which there seems to be limited oversight, which was raised in questions in the House either today or yesterday, is the way in which the taxpayer legitimately subsidises unpopular political parties through the Short money. I am not questioning the principle, which is accepted—

Peter Bone: You did say unpopular political parties. Were you referring to the Conservatives—

Mr. Deputy Speaker: Order. I said nothing. I think that the hon. Gentleman means the hon. Member.

Peter Bone: I apologise, Mr. Deputy Speaker. Was the Minister referring to the Conservative party, which won the most votes in England at the last general election, and which represents constituencies covering three quarters of the geographical area of England?

Jim Murphy: Of course I was, but the Liberal Democrats have also had vast sums of public money invested in propping them up. I am not questioning the principle of that. On a much wider point, this was a UK Parliament the last time that I checked, for UK politicians and from a UK general election. If the hon. Gentleman wishes to create an English Parliament—

Oliver Heald: Will the Minister give way?

Jim Murphy: Time is running out, and the hon. Gentleman will have time to respond to this point and the one about shadow Ministers' accountability when he winds up.
	There is a UK Parliament and a UK general election, and we are elected here by our constituents. I hope that the previous intervention was not some sort of sideways endorsement of the Liberal policy of proportional representation, on which we would disagree strongly. On the question of Short money, some people have started to ask about value for money and the public ethics of it. I will leave that legitimate point there, and the hon. Gentleman might respond to it later.
	I will try your patience, Mr. Deputy Speaker, if I continue for much longer on the question of Opposition accountability in relation to the ministerial code and use of taxpayers' money—£22 million of it since 1997. I want to thank the Conservative party, however, and I look forward to hearing whether it is willing to adhere to the same standards as Ministers.
	Had it not been for the galling sight of two Ministers committing perjury, and for the fact that a number—not all—of Conservative Members of Parliament were lining their own pockets from asking questions in this Chamber, the momentum for many reforms, in terms of the growth in regulation of our body politic, important decisions about the ministerial code, openness in government, overseas donations and publishing the list of gifts to Ministers, would not have been in place. In that at least, we find common cause. We thank the Conservative party for getting itself into such a mess prior to the 1997 election that we have been forced to clean that up. We do not, however, feel any sense of complacency, and we will continue to find ways of improving our body politic. That is an issue on which the public will judge us each and every day, and come the general election.

David Heath: I support the motion, and I am disappointed that the Government did not feel able to support it as well. It would have been far better had the House been able to unite on a common view of what is needed to maintain the integrity of both the Government and the House. If the Minister wishes, he can close his eyes tight and not see the obvious concerns being expressed outside the House, but I strongly advise him not to do so, because this is a matter of considerable concern.
	Let me give the Minister credit: he is right in some of what he has said about what the Government have done to improve the situation. The publication of the ministerial code, in the form in which it has been published, is an improvement, and there have been other improvements to which the Minister can rightly draw attention. He was in danger of overstating the case on the Freedom of Information Act 2000, though, particularly when he said that Opposition parties—plural—opposed it. I think that the Liberal Democrats have been the strongest advocates of freedom of information for a very long time.
	The Minister will recall that a former Chancellor of the Duchy of Lancaster, David Clark—now Lord Clark—was the author of much more extensive provisions for freedom of information than the Government were, in the end, prepared to accept. Even the rather meagre provisions of the Freedom of Information Act have been largely circumvented whenever possible by some members of the Government ever since. The Minister should be cautious about such matters. As I have said, we should recognise that there have been advances since the time of the last Government, but the Minister should recognise that there are genuine concerns.
	The Minister referred to the comment by Sir John Major, the former Prime Minister, that he preferred to deal with breaches of the ministerial code by providing a glass of whisky and a pearl-handled revolver in a darkened room—[Hon. Members: "Brandy!"] I am sorry: brandy. How different that is from the position of the Secretary of State for Work and Pensions in recent weeks—but, in fact, we are in exactly the same position, and I think that that too is of concern.
	Is the ministerial code properly constructed? Is it properly policed? If the answer to either of those questions is in the negative, are there alternatives that we can consider? When we deal with matters of this kind, the House is in danger of resembling a mud-wrestling competition. We must try hard not to descend to party-political tit-for-tats, because that does none of us any good in the end. I think the Conservatives would be wise to accept, however, that the last Conservative Government had a real problem. They were considered by many to be "enmired in sleaze"—the term that was used at the time. Of course that did not apply to every member of the Government or every member of the Conservative party, but it was the perception at the time.
	I think it is also fair to say that the present Government are not yet in the same position. When Sir John Major claimed recently that Labour was now more sleazy than his own Government, Sir Alistair Graham said
	"Our recent work has suggested that this government has been rather less guilty of sleaze of which the Major government was accused and more guilty of spin, of over-exaggeration of achievements to try and gain support rather than direct sleaze."
	With that somewhat faint praise, we can accept that the Government, although moving in a direction that none of us would wish to see, have not yet achieved the position that the public perceived the John Major Government to be in.

Tony Wright: In a spirit of total fairness and complete historical accuracy, will the hon. Gentleman also put on the record the fact that the last Liberal Government were also immersed in sleaze?

David Heath: Yes, and is it not interesting to note that the forerunner of the ministerial code was published in 1917 under the prime ministership of David Lloyd George—a great Prime Minister of this country, but someone who was prepared to sell peerages in return for donations? Well, that could never happen now, could it? At least Lloyd George had the clarity and transparency to provide a clear tariff, so everyone knew what was happening, but the hon. Gentleman is absolutely right to make that point.
	The Minister said earlier that sleaze was endemic in the Major Government. It may have been, but many of us are concerned to prevent that endemic disease from becoming a pandemic, in which all political parties are seen in exactly the same light as that historical position in respect of the Conservative party under Major. Complacency is greatly misplaced on this matter, as it does not take much to cause a generalised infection. I would like to quote a gentleman called Paul Masefield, speaking on Star Sports channel:
	"One bad apple in the dressing room and everything can go pear-shaped."
	Yes, it can, and the Minister should be aware of that.
	Let us examine what the ministerial code says. Much of what it says is good. For example, it states under paragraph 1.5 that Ministers are required
	"to uphold the administration of justice and to protect the integrity of public life."
	Absolutely right. Under paragraph 1.5.f, it states:
	"Ministers must ensure that no conflict arises, or appears to arise, between their public duties and their private interests".
	Again, that is absolutely right. Then there is clear—I think, unambiguous—advice under paragraph 5.29:
	"On leaving office, Ministers should seek advice from the independent Advisory Committee on Business Appointments about any appointments they wish to take up within two years of leaving office."
	I find it very difficult to understand how anyone could misunderstand that particular provision.
	In some aspects, then, the ministerial code is well constructed, but I could also cite paragraph 1.3, which states:
	"The Code is not a rule book, and it is not the role of the Secretary of the Cabinet or other officials to enforce it or to investigate Ministers, although they may provide Ministers with private advice on matters which it covers."
	The question that people outside the House are asking is: what is the point of having rules if no one is enforcing them? The answer from the Government, of course, is that the Prime Minister enforces those rules. Well, the Prime Minister has many qualities—some good, some bad. One of his qualities that many would consider admirable is loyalty to his colleagues, but such loyalty is not a substitute for policing the ministerial code in the manner in which it should be policed. On the basis of the investigations that the Prime Minister has carried out into Cabinet colleagues over recent years, I have to say that the only possible conclusion that one can reach is that the code can be breached with impunity. That should not happen and it reflects badly on the Prime Minister as well other members of his Government.
	The hon. Member for Peterborough (Mr. Jackson), who is no longer in his place, argued earlier that Ministers were more lightly policed in respect of their adherence to standards in public life than the average parish councillor. How can that be right? How can it be that Ministers who wield enormous powers over the budgets that they control and who take such important decisions are more lightly policed in respect of standards of public life than a parish councillor who, with the best will in the world, controls very little beyond some donations to the local village hall or the local recreation field? That is a matter of genuine concern, and I simply do not accept the defence of inadvertence. Explicit advice is given in the ministerial code, and if Cabinet Ministers are inadvertent as to what they should be doing, frankly, they are not fit to be Ministers of Cabinet rank.
	So what can be done? First, we should have a debate along the lines of our perennial Standing Committee debates, in which it is often said of a particular Bill that we should delete "may" and insert "must". The ministerial code should say not that a Minister "should" do something, but that a Minister "must" do something. Secondly, there must be an absolute ban on Ministers taking up paid directorships or employment for two years following their leaving office, unless the advisory committee has said that doing so is acceptable. Such behaviour is incredibly corrosive. If Ministers are seen to be walking away from their Departments and joining companies with interests that are directly relevant to the Departments that they have just left, every civil servant will ask, "Why can't we do the same?" Every member of the armed forces who works in procurement will ask, "Why can't we do the same?" Every time that such things happen, the public's confidence that decisions are being taken with the proper interests of the country in mind is damaged.
	I set aside the question of why it is assumed that a Minister has to have a highly paid job on leaving office. I take the puritanical view that I am a Member of Parliament, and that is my job. I do not see the need to have additional jobs, but I know that other Members take different views on the appropriateness or otherwise of paid employment. What is absolutely clear is that Ministers get generous severance pay on leaving office. Indeed, sometimes they get severance pay several times over, which is another matter that we might consider.

Chris Grayling: And keep their house.

David Heath: Perhaps we ought not to consider that issue at the moment.
	When resignations occur, it is very important that the proprieties are not only respected, but seen clearly to be respected, by Ministers on leaving office. There have been several instances of repeat ministerial resignations; indeed, I am reminded of the programmes that seem to appear on satellite television every couple of days, with titles along the lines of "Britain's Funniest Ministerial Resignations". We need to police this issue very carefully if we are to maintain the general public's respect for the body politic as a whole.
	The trouble is that this is not the only issue that is in danger of souring the position of us all, frankly, and of the democratic system. Mention was made earlier of David Lloyd George's appointing major Liberal party donors to the House of Lords. He had complete contempt for the Lords, which is why he used that method, but the Lords has now changed. It is now primarily an appointed House, so it is even more important that those appointed to it are not tinged with any suspicion that the main reason for their appointment is their having donated large sums to one or other of the parties. However, there is more than a suspicion that some Members of the Lords are being appointed for precisely that reason.

Angus MacNeil: The hon. Gentleman is doubtless aware that the Prime Minister has appointed some 292 peers, so he is responsible for the creation of more Labour peers than he is the election of new Commons Members.

David Heath: The hon. Gentleman is absolutely right, but I must be very careful not to stray from the terms of the debate.
	I am trying to express the view that these issues are not compartmentalised but cumulative. If the impression is given that the main motivating factor for Ministers, civil servants or members of the legislature is the financial advantage that they may gain, we will lose something precious in our political life.
	In addition, an appalling example will be set. Ministers give a direct example to senior civil servants when it comes to what is acceptable. Mention has been made already of Christopher Meyer, who made the matter plain when he said, "If it's good enough for Ministers, it's good enough for me." I think that the book betrays some absolutely inappropriate confidences, and I look forward to learning how on earth it was given clearance—

Mr. Deputy Speaker: Order. We are straying again. I urge the hon. Gentleman to return to the terms of the motion.

David Heath: I am most grateful, Mr. Deputy Speaker. It is so tempting to stray into such matters, but of course they do not fall within the terms of the motion.
	I repeat: the standing of Government is important not only to the Government, but to the House and to the body politic as a whole. Some things can and should be done to make the ministerial code better able to police the activities of Ministers. More importantly, we must make sure that the impression is given that Ministers' conduct is of the highest integrity.
	The arguments in favour of independent investigation and of making the code clearer about what Ministers must do rather than what they might, should or could do on a wet afternoon seem compelling, to use the term of the moment. I am disappointed that the Minister could not accept that today, but I believe that the House should do so. We should give a very clear signal to the Prime Minister that our patience regarding this matter is running a little thin.

Tony Wright: I think that a tiny bit of perspective might be in order. The other day, I read again Roy Jenkins's splendid book on Churchill, in which he described how Churchill received an especially munificent gift from a benefactor. As an aside, Jenkins asks us to think what would have happened if the gift had been offered in the age of the ministerial code or parliamentary commissioner.
	In fact, ministerial conduct was not better in the past, but a good deal worse, and both main parties have spent a lot of time on improving matters. Attlee would smile to hear today's debate. After the war, he brought together the assorted bits of procedural guidance for Ministers. He sent around a note to Ministers, in which he said that that collection of guidance might be "convenient" for colleagues.
	Attlee's version of the code had 65 paragraphs. By 1997, the code had grown to 135 paragraphs, and its latest edition has 173. The code is now expected to cover everything, from air miles to lottery bids. That shows that a good deal of attention has been given to the document over the years.
	Given the exchanges in the debate so far, it is worth remembering that both major parties have strengthened the ministerial code, and also resisted suggestions about how it could be strengthened. I sat on the Opposition Benches in the 1990s, when the Committee on Standards in Public Life had just been set up. One of its first recommendations was that the Prime Minister should take responsibility for the code. The Committee said that it should not be left to Ministers to behave properly, but that the Prime Minister should assume formal responsibility for the code. It should be his document. That proposition was resisted by John Major, with all the authority he had. However, the proposal was incorporated into the code by this Government, so the first section now states that the Prime Minister will take responsibility for the conduct of Ministers. I believe that that is an advance.
	I suggest that not only has the ministerial code grown in status and size, but the whole of the ethical regulation of Government has grown. We now have an army of ethical regulators, who have usually been introduced in response to some crisis or scandal. We have the Committee on Standards in Public Life, the public appointments commissioner, the Parliamentary Commissioner For Standards, the advisory committee on business appointments, the civil service commission, a new Electoral Commission—which addresses issues such as party funding that were once seen to be outside any kind of regulatory structure—and a standards board for local government. We have a crowd of ethical regulators and a crowd of codes governing behaviour in various areas. We have a code for Ministers, now published and ever expanding, covering ever more areas. We have a code for civil servants and for special advisers. Now we have demands that some of those codes should be converted into legislation.
	It is not as though we have been casual in the matter of the ethical regulation of Government in recent times. Ethical regulation has grown in importance and is now on the scale that I have described. As a result, has trust in Government and the political class increased or decreased? I am afraid that it has decreased, and that is what should concern us in this debate, instead of playing the party games of saying, "Oh, you were worse than we are", and replying, "Oh no, you are worse than we were." That brings the whole of public life down, because it is comfortable for a large section of the public to think that the political class is sleazy and corrupt. The newspapers love to feed the idea that the political class is sleazy and corrupt. It sells newspapers and feeds the popular assumption. We also feed that by always saying that the other lot are more corrupt than we are. We have all been guilty of that. We were guilty of it in the 1990s, although it must be said that we had rich material to work with. In any case, we exploited it for all it was worth, because of the great political dividend it provided. As my hon. Friend the Minister pointed out, the Conservatives—rationally, from their point of view—said, "Look, we're suffering a great disadvantage in the sleaze stakes, because people think that we are sleazy. It is essential that we make people realise that the new lot are as sleazy as we were." They have had a concerted strategy to achieve that, which is rational in its own terms, but mutually ruinous for the standing of politicians and political life.

Nicholas Winterton: I am listening to the hon. Gentleman's remarks with care and agree with much of what he says. Does he believe that hon. Members are now less honourable than they were in years gone by? Does he feel that the failure of Ministers to resign when they have done wrong—they now have to be forced to resign—is also an indication that we now have career politicians rather than Members who come here to serve the people of their constituencies and the country?

Tony Wright: I am grateful to the hon. Gentleman who raised several points. I shall deal with two of them if I may. First, do I think that standards have gone down? No, I do not; they have gone up quite considerably. The tragedy is that we have given people grounds to think that standards have gone down while in fact they have been rising. Not only have they gone up, but any intelligent historical or comparative tests show that we probably have the least corrupt way of doing politics of almost any political system in the world—across party. Why then do we spend so much effort trying to suggest that our political opponents are corrupt and sleazy? We do so because we think there may be some temporary political advantage in doing so. That brings me to the hon. Gentleman's second point, which is about resignation.
	The hon. Member for Epsom and Ewell (Chris Grayling) has never knowingly undersold when making allegations against Ministers, usually demanding their resignation. But when someone jumps up every time anything happens, however minor, saying, "This is a scandal. This is outrageous. This is a resigning matter", when they go through the whole hyperbolic routine, the effect is to diminish regard for political life. Indeed, it loses the sense of the moment when that kind of language is required because something serious really has happened. Across the House, we have a responsibility to be far more intelligent and sensible about such matters.

Chris Grayling: I challenge the hon. Gentleman to identify a single occasion on which I have ever been reported as calling for the resignation of a Minister.

Tony Wright: That is the impression that the hon. Gentleman has given me and many other people. I really am not making a party political point and I am certainly not making a personal point. We would be doing just the same thing. We would have the same knee-jerk reaction: talking up the incident to make it a major constitutional scandal, expressing outrage that standards of conduct in Government had been breached and suggesting that the consequence should be a ministerial head rolling. I merely suggest that that is not an intelligent or sensible way of doing politics—not if we care for the regard in which, on the whole, an uncorrupt political system is held by the people we represent.
	I conclude, therefore, that it is not necessary or desirable to think about inventing yet more ethical regulators, as the motion proposes; it would simply be desirable, in terms of the motion, to correct the wording in the ministerial code. If the motion proposed that the words "are advised to" in paragraph 5.3,
	"Ministers are advised to provide their Permanent Secretary with a full list . . . of . . . interests",
	be changed to "should", I would give it my wholehearted support. That is all that is required.
	It would diffuse accountability to the House if the proposition is that we introduce another ethical regulator on to such a crowded field, when it is actually entirely clear—or should be—what Ministers should do and what permanent secretaries should do. Once we begin to cloud the process, and other people are involved, accountability is diminished and diffused rather than enhanced.
	Earlier, I made the case for an independent investigator, a point that was raised by the Public Administration Committee back in 2001, long before the Committee on Standards in Public Life got involved. For all kinds of reasons, I am as attached to that proposition now as I was then. The time has come to take a fresh look at the whole field of ethical regulation—all the bodies that we set up for particular reasons at particular moments—and to try to sort them out. As part of that sorting out, I hope that we shall introduce an independent investigatory element.
	I end by saying that the Prime Minister said that
	"no one will be better governed through fine-tuning the ministerial code."—[Official Report, 13 July 2000; Vol. 353, c. 1098.]
	I have some sympathy with that view, but people will be better governed if they have more confidence than they now do in the system that we have to maintain probity in government. That is a serious matter; it deserves to be taken seriously, but we are not well served if we play party games with it because we will find that we are all brought down by that and the whole of public life will suffer as a consequence.

George Young: It is a pleasure to follow the hon. Member for Cannock Chase (Dr. Wright), who speaks with great authority, conviction and knowledge on the subject. I concur particularly with what he said towards the end, but I wonder whether he asked himself the right rhetorical question halfway through his speech. The question he posed was whether public trust and confidence in us was increased as a result of what he described as the crowded field of ethical regulators. He concluded that, although standards may have risen, public confidence had decreased. The real question is where would public confidence have been if we had not responded to the concerns over the past 20 or 30 years and done nothing—if we had not set up the Register of Members' Interests and the House procedures to deal with MPs' conduct. If we had not responded as we have, public trust in us would be lower than it is at the moment.
	Earlier in the debate, a number of hon. Members wandered down memory lane and exhumed unhappy incidents in the Conservative party's past. I am not sure whether the House is at its best when it engages in such exercises. Despite the incidents that have been shared by hon. Members on both sides of the House, I do not take the view that Ministers in this Government are basically sleazy, any more than those in the Major Government were. The Minister was on rather thin ice when he tried to claim some moral superiority for this Administration.
	Fallibility is politically neutral. One or two individuals in both parties have made mistakes and paid a price. That has not infected the integrity of the political process in this country. By any international or historical standards, the integrity of the process of government in this country is remarkably high. We have a vigilant and at times over-intrusive press, a basically apolitical civil service, a fairly transparent decision-making process and an effective system of parliamentary accountability through Select Committees. As a result, there is a very high chance indeed that any irregularity will come to light, and when it does, judgment can be swift and harsh.
	I agree, however, with those hon. Members who have said that there is no room for complacency. There is scope for improvement, not least because the perception outside the House is very different from the reality; and in our business, perception is crucial. That is why I welcome this debate on oversight of the ministerial code, which has a role to play in improving the perception, but it will not do so it on its own. In addition to an up-to-date and properly enforced ministerial code, the Government need to take action on party funding and, in particular, to put a cap on large donations, which would, in turn, remove any suspicion that money secures a place in the House of Lords or influences Government policy. We need a civil service Act, for which there is still no timetable, to regulate the interface between the Government and the civil service and, in particular, to clarify the role of special advisers.
	You have indicated, Mr. Deputy Speaker, that you do not want a digression into the Meyer memoirs, but paragraphs 9.17 and 9.18 of the ministerial code deal with the publication of ministerial memoirs. All that I would say in passing is that, if Lord Armstrong and Lord Butler are correct when they assert that the relationship between Ministers and civil servants is threatened if memoirs break confidences, that is true irrespective of whether the confidence is broken by one side or the other. There is a strong argument for a level playing field because at the moment people see Ministers publishing their memoirs without any consequences, but if a civil servant does that, having apparently gone through the requisite procedures, he is criticised without restraint by the Foreign Secretary on the "Today" programme. The rules should be consistently drafted and applied right across the board, but that does not seem to be the case at the moment.
	I want to devote the substance of my brief remarks to comparing the enforcement of the code with which we are all familiar—the code for Members of Parliament, which was revised in July—with that for Ministers to determine whether we can learn from each other. Both codes have the common purpose of promoting high standards of conduct in public life, but they have important differences. One is the property of the House, while the other is the personal property of the Prime Minister—we enforce ours and he enforces his. That reflects the different lines of accountability: that of Ministers to the Prime Minister for their appointment and, indeed, survival, and ours to our electorate through the House.
	There are differences, however. Members have security of tenure and a complaint against a Member usually does not precipitate a collapse in confidence in him or her. Allegations against Ministers are slightly different because collective responsibility means that they have the potential of spreading to the Government as a whole, which risks a more generalised crisis of confidence.
	There are two key procedural differences. First, the House has built its procedures around a strong independent component: the Parliamentary Commissioner for Standards. His report is always published alongside that of the Select Committee on Standards and Privileges, and if the Committee disagrees with him, it must say so and explain why. The fact that that strong independent element is built into our system enhances the credibility and integrity of our self-disciplinary procedures. The second difference is that we have clear rules and procedures on how our system works. For those who are interested, they are available in detail on the Parliamentary Commissioner's website. Neither of those two key features is present in the ministerial code, which weakens its impact and credibility.
	Taking the second point first, the enforcement of the ministerial code is shrouded in secrecy. In the polite language of the Library brief on today's debate:
	"the Code is silent on the means by which allegations should be investigated."
	Indeed, paragraph 4.77 of the Neill report says:
	"In our view, while the Parliamentary route is well-defined by established procedures, the procedure for holding Ministers to account by the public is less clear".
	The follow-up report in 2003 of the Committee on Standards in Public Life advocated mechanisms for investigating alleged misconduct by Ministers, which brings me to the second difference between the codes: the lack of an independent element.
	In the 1997 Parliament, I had reason to believe that a junior Foreign Office Minister had broken the code, so I wrote to the Prime Minister, as custodian of his code. He did not investigate the matter, but passed the letter to Robin Cook, the then Foreign Secretary, who exonerated his colleague of any breach. We need not debate now whether there was a breach of the code, but what cannot be right is the process. The Prime Minister played no part in seeing whether his code had been observed. That was sub-contracted not to an independent observer, but to the Cabinet Minister of the Department in which the alleged breach took place. When I gave evidence to the Neill Committee, it shared my concern about what I called the circularity of the procedure.
	The new code that was published in July does not address either of those two weaknesses. It rejects the recommendations on an independent element that were made by what had by then become the Wicks committee, and there is no clarity on procedure. There has been minor drafting amendment to allow for the possibility of external advice on Ministers' private interests, but the Government rejected the recommendation that two or three senior individuals should be appointed at the beginning of each Parliament to be available to investigate allegations of ministerial misconduct.
	One advantage of having clear and well-publicised procedures for handling complaints against MPs is that when questions about Members arise, they can be considered in a way that takes them—at least temporarily—out of the party political arena. If similar processes could be established in the ministerial area, it would be to the advantage of all parties as well as to the benefit of the public standing of politics in general.
	Another feature of our own arrangements is the ready availability to Members of impartial advice on their obligations under the code and rules. While permanent secretaries advice their Ministers on obligations under the code, they are not in turn supported by a source of independent advice about tricky cases to which both they and Ministers themselves can turn. The Minister might argue that the propriety and ethics team at the Cabinet Office—a body of men that the hon. Member for Cannock Chase omitted to mention when he described the regulatory field—already performs that function, but I am not sure that it would be seen to be independent.
	The Wicks committee, which has of course now become the Graham committee, has expressed regret at the Government's decision not to proceed with the recommendations. The chairman set out his views in more detail in The Independent on Sunday on 6 November.
	The Government amendment has a welcome element, although they have never explained why they have taken so long to make progress, but the more that I listened to the Minister explain why the Government were rejecting the other recommendation about the independent panel, the less obvious the gap was between what the Government are now doing and what the Graham committee is advocating. The Prime Minister is prepared to draw on independent people in certain cases to investigate, and if so, what is the difficulty about the recommendation? I have high hopes that the new head of the civil service will apply his mind to those issues, and I am sure that the Public Administration Committee will want to review the matter.
	I end on the point that independence and clarity are key features of the system of holding Ministers and Members to account. The system that the House has developed for its own procedures has that element of independence and clarity. I do not think that the ministerial code does so, and for that reason I hope that it may be further amended.

Oliver Heald: We have had an excellent debate, to which my right hon. Friend the Member for North-West Hampshire (Sir George Young) made a notable contribution. As Chairman of the Standards and Privileges Committee, he is able to bring his experience of many complaints against Members of Parliament and how they have been dealt with, and to compare that regime with what happens to Ministers under the ministerial code. When he asked where confidence would be if nothing had been done—if we had not had the register, the Committee of Standards and Privileges and the other changes—I agreed with his point.
	That contrasted with the point made somewhat unusually by the hon. Member for Cannock Chase (Dr. Wright), who took an establishment view that we should just stop talking about possible breaches of the ministerial code and try to reduce the number of regulators, and everything would be all right. He must accept that there has been a change in culture over recent years, partly to do with the fact that previously Members of Parliament were paid very little and had outside interests, whereas now that is not the case. The public now expect transparency in what we do and to have an independent element of both advice and investigation.
	The Government's amendment and the Minister's speech were—

Jim Murphy: Excellent.

Oliver Heald: The Minister may say that, but to me he sounded slightly pompous when he said, "Oh well, we can have the independent adviser and we will make an announcement shortly." Surely the public would react to that attitude by saying, "My goodness, can't they just say they'll do it?" The Minister also showed a certain complacency when he appeared to suggest that everything that the Government do is above board and that there was never a problem.
	I began to think about a civil service Bill, on which I initiated a debate last year. Since 1997, the Government have been promising a civil service Bill, and to be fair to the hon. Member for Cannock Chase, he drafted one. I tried to debate such a Bill in the House, and when I managed to do so the Government said that they would be doing something in due course. Yet here we are today—1997 is a long time ago—and we still do not have a civil service Act on the statute book. The question of whether we are to have independent mechanisms to make the ministerial code work seems to be going the wrong way.

Tony Wright: One reason why we do not have such a Bill—I have heard this not just from Ministers but from senior civil servants, both serving and retired—is that people are terrified that Members will revert to type and simply play political games with its content. The last Conservative Government asked for an assurance that a measure could be introduced on a bipartisan basis. If the present Government could be confident that that was the case, more progress could be made.

Oliver Heald: The hon. Gentleman can look at Hansard, but I offered every possible co-operation and received nothing in return.
	In 2003, the Committee on Standards in Public Life made those two recommendations. The Government accepted the need for an adviser on ministerial interests. It is extraordinary that the Minister felt it necessary to rake up all the old dirt from years ago, as we are suggesting that he should do something to which the Government have already agreed. Even so, they still will not establish such a post. The heart of the problem concerns the Prime Minister and his wish to remain unfettered by controls such as a civil service Bill and an independent mechanism to monitor compliance with the code. We could probably achieve consensus on a range of measures, so it is sad that the Prime Minister should say that the Government are not prepared to go down that route.
	The Prime Minister's involvement in various incidents in recent years demonstrates why the problem has arisen. When the committee made its recommendation two years ago, it did not allow it to rest. Sir Alistair Graham has said on three recent occasions that the matter must be pursued. He said so at the beginning of this Parliament, and he said so again in July, when the code was issued, even though his committee was not consulted about it. He made the point, however, that we should have a ministerial adviser. During the recent troubles of the right hon. Member for Sheffield, Brightside (Mr. Blunkett) he made the point again. In The Independent on Sunday he said:
	"In the end it is a matter of style, tone and leadership of the Prime Minister. In the end, that's the central issue".
	He said that those rules should be strictly adhered so that
	"everybody knows that if they step out of line, they won't get a second chance."
	Sir Alistair went on to say that if, as the Prime Minister has done,
	"you sign up to a foreword to the Ministerial Code in which you expect ministers not only to sign up to the letter but the spirit as well . . . then if your actions don't live up to those words you're in danger of getting criticised and being perceived to be weak . . . and there is a danger that the Prime Minister could be under that charge".
	Sir Alistair does not take the same view as the Prime Minister of the incident involving the right hon. Member for Sheffield, Brightside. He asks:
	"How many people in this country have the opportunity to invest £15,000 to possibly get back £300,000 within a few months' time? . . . You can give a rather obscure and muddied message about ethical standards. These issues in the end are always matters of leadership."
	He made the point that Parliament and the entire political class will suffer a serious loss of confidence if they do not take those issues seriously. I am not suggesting that we should make changes just for the sake of it.

Fraser Kemp: The hon. Gentleman talked about a loss of confidence in Parliament and the political classes. May I return to my earlier point and ask whether he is prepared to endorse the recommendations of Lord Neill of Bladen, who told the Committee on Standards in Public Life that the application of the code of conduct to members of the Opposition Front Bench warrants investigation? In the past, shadow Chancellors have received money from oil companies but have taken part in Divisions on fuel tax. That is not acceptable and diminishes the House. Will he accept Lord Neill's recommendations—yes or no?

Oliver Heald: Lord Neill made his recommendation some years ago. The hon. Gentleman may wish to know that since that time hon. Members on the Opposition Front Bench have taken advice from the Parliamentary Commissioner on these matters, and in recent years there have been no examples of the sort that the hon. Gentleman mentioned. Those who wish to be shadow Chancellor give up interests that might conflict.
	The Prime Minister writes in the forward to the code that he expects Ministers
	"to work within the letter and spirit of the Code",
	but it is clear that Ministers need a little more help. It may be that they find it hard to ask for or accept advice from their senior civil servant. Perhaps the evidence that the Public Administration Committee received from Sir Robin Mountfield shows that senior civil servants also find the present position difficult. The culture is changing from one where people used to resign quite readily to one where they hardly ever do.
	The issues that cause the difficulty are not so much those where there is a clear disaster in the Department or a clear problem resulting from a Minister's work. The real problems are the cases of actual or perceived conflict of interest. Those are the ones where the new adviser would be most useful, bringing an independent element, available at an early stage, before the Minister acts ill-advisedly. As the hon. Member for Somerton and Frome (Mr. Heath) pointed out in an excellent and measured contribution, what is the point of rules if they are not properly policed and if independent advice is not available?
	It is not good enough to wait until Parliament is asking questions and the media are sniffing about. We need proper advice for Ministers at an early stage. I like the recommendation about the panel of investigators too, for the reasons that my right hon. Friend the Member for North-West Hampshire and others made clear, but the new adviser would be useful to Ministers in a range of ways on questions not just about their own position, but about spouses, relatives and the like. The outside world sees conflicts of interest and expects them to be stopped. Often the Government do not recognise them. Independence is vital in terms of advice and oversight, because often the Prime Minister is not a neutral and disinterested arbiter.
	When the Labour party took £1 million from motor racing and then delayed the ban on tobacco advertising, it was the Prime Minister who was in the front line having to defend that. It seemed like a conflict of interest, but he said:
	"I'm a regular kind of guy",
	and somehow it was not a problem. It was he who wrote the controversial letter in the Mittalgate scandal, asking a foreign Government for a contract for a Labour donor. It seemed like a conflict of interest, but he said no, it was not.
	When Peter Mandelson accepted a loan of £373,000 from the hon. Member for Coventry, North-West (Mr. Robinson) to buy a house in Notting Hill, he was Secretary of State for Trade and Industry and had oversight of inquiries into the hon. Gentleman's business dealings. It seemed like a conflict of interest, but not to the Prime Minister. It must have done to Mr.   Mandelson, because he resigned—but not to the Prime Minister, who said he had done nothing wrong. In the Hinduja passport affair, where wealthy brothers donated £1 million to the faith zone of the dome when Peter Mandelson was the Minister, he called the then Minister with responsibility for immigration matters, now the Solicitor-General, the hon. and learned Member for North Warwickshire (Mr. O'Brien), to inquire about their passport applications, which I believe were then granted. It seemed like a conflict of interest. Mr. Mandelson resigned, but the Prime Minister said that he had done nothing wrong.
	Then we come to the right hon. Member for Sheffield, Brightside and shares owned in a company bidding for work in his Department. It seemed like a conflict of interest. The right hon. Gentleman resigned, but the Prime Minister said that he had done nothing wrong, except that there had been a technical breach, and he left office without a stain on his character. On each of those occasions, there was a public perception of a conflict of interest and a Prime Minister in denial. It would be much better if we had a robust and transparent process with an independent element of investigation and advice, which would deter Ministers from sailing too close to the wind and enable them to take independent advice confidentially and without involving their civil servants. The funny thing is that although the Government have agreed to that step, they will not approve the motion.

Tony Wright: I keep reminding the hon. Gentleman that the motion does not propose the appointment of an independent investigator, which is sensible. It proposes the appointment of an "Adviser on Ministerial Interests", which is not sensible. I agree neither with the Opposition nor with the Government, who have, however, agreed to the proposal.

Oliver Heald: The Government have agreed to such an appointment, but they keep dragging their heels, as they do over a civil service Bill. The Prime Minister does not like independent oversight and does not want to be fettered, but it is time for Ministers to make that change and for Parliament to have an extra independent element.

Jim Murphy: The debate has not been especially long for a variety of reasons, but we heard some high quality contributions from Back Benchers.
	On the points made by the hon. Member for Somerton and Frome (Mr. Heath), we continually review the ministerial code, which is published after each general election. We take account of suggestions and recommendations from various Committees, including the Public Administration Committee and the Committee on Standards in Public Life. The precedent has been established, and I think that it will continue, because it would be remarkable if that procedure were turned on its head.
	The hon. Gentleman made a fair speech and tried not to sound supercilious, but I remind him that a halo needs to slip only a foot or two to become a noose. It would be interesting to know whether the Liberal Democrats intend to return the £2.4 million dodgy donation from a Swiss bank account in line with his comments this evening.
	Both Opposition and Government Members acknowledge that my hon. Friend the Member for Cannock Chase (Dr. Wright) speaks with an enormous amount of experience and authority—he keeps Front Benchers on both sides of the House on their toes with his analysis and his experience. He has announced the PAC investigation into who regulates the regulators, and we will pay close attention to the evidence and the PAC's recommendations, as we always do and always should do.
	The Cabinet Office has a vested interest, because it is responsible for the better regulation agenda. At least 12 organisations oversee the probity and ethics of the body politic, and the question is whether we need a 13th—my hon. Friend's Committee may make such a recommendation. My hon. Friend is right that enhancing public faith in politicians from all parties and in Governments—this one, the previous one and any future one—will not be achieved by tinkering with the details of the ministerial code. Although the ministerial code will continue to evolve, it is not a silver bullet to maintain public faith in politics. A much wider debate is taking place not only in this country and this Parliament, but across the world about the connection between the elector and the elected, and all Governments and Opposition parties across the world are grappling with it. I think that faith in politics and the political process will be enhanced not by tinkering with the ministerial code but by delivering real improvements in people's lives and then connecting those improvements to decisions that the Government, whom they have elected, have taken in respect of unemployment, the economy and investment in schools. Such improvements will drive up trust and faith in politics and the political process much more than any squabble across the Dispatch Box about independent assessment of business regulation and the ministerial code.
	The right hon. Member for North-West Hampshire (Sir George Young) again demonstrated his enormous experience. We have been helped by the fact that although there were only two Back-Bench speeches they came from the right hon. Gentleman and my hon. Friend the Member for Cannock Chase, both of whom made important and detailed suggestions. Instead of making a knee-jerk response to the right hon. Gentleman, I will reflect on some of the specifics that he mentioned and offer a more considered response. He mentioned the propriety and ethics team in the Cabinet Office. I add my tribute to the work of the men and women in that team. I will not be alone in thinking that we should have heard the right hon. Gentleman's speech delivered from the Front Bench instead of the two speeches that we did hear.
	The hon. Member for Epsom and Ewell (Chris Grayling) started by saying that he did not want to rake over old coals, and then proceeded to do so. Again, he behaved like a copywriter for the Daily Mail or, on a good day, The Mail on Sunday. He was challenged by my hon. Friend the Member for Cannock Chase on the issue of demanding resignations based on ministerial conduct. I am not able to name and shame the hon. Gentleman on specifics, but he generally uses the tried and tested approach of demanding action based on growing concern expressed in the Daily Mail and The   Mail on Sunday. That concern gets into those newspapers because he issues a press release demanding action on it, so the concern that he says is growing is one of his own creation.
	For example, the hon. Gentleman wrote to Ministers challenging the use of public funds on a flight by the Prime Minister to Singapore and then on to Riyadh. I imagine that the Prime Minister must have been in Singapore supporting the 2012 Olympic bid, and I know that he was in Riyadh for a very good reason. The response to the allegation is that there are no scheduled flights between Riyadh and Singapore. Once again, an accusation made publicly in the press turns out to be founded on nothing but speculation and tittle-tattle. That is only the latest example of the hon. Gentleman performing that sort of activity.
	The hon. Gentleman is right to say that we do not yet have a civil service Act. However, we now have a draft civil service Bill on which we have consulted. In 18 years of Conservative government, we had neither a Bill nor a consultation. The hon. Gentleman, like others, will have to be a good deal more patient. We have waited 148 years for the draft Bill, and he can wait a little longer.
	In previous years, a debate on Government ethics and ministerial conduct would have taken place in a packed Chamber. It would have been tense and highly charged, with the cut and thrust of a parliamentary event. This evening's debate was attended by perhaps 10 Members, although I am sure that everyone else had important business to attend to.

Oliver Heald: Surely the Parliamentary Secretary accepts that we are asking the Government to do something that they promised to do. It is obvious that nobody believes that that will happen.

Jim Murphy: In the hon. Gentleman's winding-up speech, he argued for something that was not even in the motion and had to be clarified from the Labour Back Benches. It is a short motion but he managed to fail to understand what it demanded. He made up a whole speech on an entirely different matter, which did not appear in the motion.
	Opposition Members mentioned complacency, but only six Opposition Back Benchers were present this evening. That does not suggest great demand to discuss—or difficulty with—issues of propriety and public service. However, the idea that there is complacency about those matters is wide of the mark. We are clearing up many of the issues that the Conservatives left unresolved in the 1990s. We are the first Government to publish the ministerial code, introduce a Freedom of Information Act and clean up party political funding. It is clear that those measures have helped to increase public trust in politics and will continue to do that.
	Earlier, my hon. Friend the Member for Houghton and Washington, East (Mr. Kemp) asked whether the Opposition would abide by some of rules and regulations that they understandably expect Ministers to obey. The hon. Member for North-East Hertfordshire (Mr. Heald) was silent on the matter. Will he confirm that all members of the shadow Cabinet will voluntarily or collectively adhere to a similar set of principles to those by which Ministers are expected to abide?

Oliver Heald: I am sorry if the Parliamentary Secretary was not listening but I answered the question. I said that the report to which he referred was from some years ago and that the practice now is, as I described, in line with the principles.

Jim Murphy: I am not sure what that mumble was.

Angela Browning: The Parliamentary Secretary knows that I have listened to the whole debate. It is a bit rich for him to talk about the principles to which Ministers adhere. When I asked him to define the seven principles of public life, he could not relate one. I know that the list has now been sent down from the Box. Would he like to read them out simply to fill up the next three minutes? The other Ministers present might be enlightened about the principles by which they are meant to be living.

Jim Murphy: The hon. Lady is one of the few who attended the whole debate. [hon. Members: "Read them out."] I shall not read them out. Time will not allow me to do that.
	In his winding-up speech, the hon. Member for North-East Hertfordshire referred to the former Secretary of State for Work and Pensions. My right hon. Friend the Member for Sheffield, Brightside (Mr.   Blunkett) visited my constituency during the election campaign. He had a good campaign visit. However, one lady in particular was very keen to meet him. She approached him and said, "Mr. Blunkett, I'm delighted that you've come to East Renfrewshire. I wanted to meet you to tell you how much I dislike you." I do not know how many hon. Members have shared such a campaign experience. Of course, my right hon. Friend committed a technical breach of the ministerial code and he paid for it with his political career. That is a heavy price.
	However, I reiterate that it is a world away from Conservative Members being paid to ask questions in the Chamber with brown envelopes in their pockets. It is a different world from former Conservative Cabinet Ministers occupying Belmarsh rather than the Opposition Benches—as I said earlier, Belmarsh was on the verge of setting up its own Conservative Association because so many Conservatives were being locked up there. It is a far cry from Ministers having to resign because they were trying to block investigations into the cash-for-questions inquiry.
	The fact is that we have introduced a whole series of firsts: the first ministerial code; the first Freedom of Information Act; the first draft civil service Bill—

Patrick McLoughlin: rose in his place and claimed to move, That the Question be now put.
	Question, That the Question be now put, put and agreed to.

Question put accordingly, That the original words stand part of the Question:—
	The House divided: Ayes 229, Noes 288.

Question accordingly negatived.
	Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
	Mr Speaker forthwith declared the main Question, as amended, to be agreed to.
	Resolved,
	That this House acknowledges that, amongst other measures, this Government introduced a requirement for individual Ministers, on appointment to each new office, to provide their Permanent Secretary with a full list in writing of all interests which might be thought to give rise to a conflict; welcomes the section of the Ministerial Code on handling Ministers' private interests which is more comprehensive than Questions of Procedure for Ministers; and recognises that this Government has agreed to appoint an independent adviser to provide Permanent Secretaries and Ministers with an additional source of professional advice as required and will make an announcement on this shortly.

EUROPEAN UNION DOCUMENT

Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),

Marketing of Foods Derived from Genetically Modified Maize

That this House takes note of European Union Document No. 12197/05, draft Council Decision authorising the placing on the market of foods and food ingredients from genetically modified maize line MON863 as novel foods or novel food ingredients under Regulation (EC) No. 258/97; and supports the Government's view that products derived from this maize meet the necessary requirements for authorisation under Regulation (EC) No. 258/97.—[Mr. Heppell.]

Mr. Speaker: I think the Ayes have it.

Hon. Members: No.
	Division deferred till Wednesday 16 November, pursuant to Standing Order No. 41A (Deferred divisions).

PETITIONS
	 — 
	IsItFair Campaign

Jeremy Browne: I wish to submit a petition on behalf of my constituents who support the IsItFair council tax protest campaign. There is considerable concern and unease in my constituency about rising council tax bills, which particularly penalise people on low and fixed incomes—especially pensioners and people on the typical wages in my constituency.
	The petition states:
	The Petitioners therefore request that the House of Commons votes to replace Council Tax with a fair and equitable tax that, without recourse to any supplementary benefit, takes into account ability to pay from disposable income, such tax to be based on a system that is free from any geographically or politically motivated discrimination, and that clearly identifies the fiscal and managerial responsibilities of all involved parties.
	And the Petitioners remain, etc.
	To lie upon the Table.

Post-16 Education (Funding Inequalities)

Frank Cook: In April this year, I was visited by two young students, who complained about the inequality of funding between their sixth form school and colleges of further education. They were most anxious to make an impact on what they saw as an inequitable position. On seeking my advice, the best I could give them was that they should start up a petition and secure as many signatures as possible to support their cause. They have done so, but with the general election and summer recess intervening, it has come back to life only now.
	The two students were Linzi Cooper and Emma Lavery, students of Bede college, Billingham and the petition relates to the residents of Billingham and others.
	The petition states:
	That students of Bede College are proud of their OFSTED report, which found that "levels of achievement are high and few students leave the college before completing the course", but that students are anxious at the concerns of Principal Mrs. Miriam Stanton who said, "while current performance is good we are very worried that we can not invest enough in developing our buildings, our equipment and our staff to preserve this for future students".
	The petitioners list five strong bullet points and pray that the Government take account of them and put into action all their claims
	at the earliest possible date.
	And the Petitioners remain, etc.
	To lie upon the Table.

IsItFair Campaign

Chris Grayling: My petition from constituents in my Epsom and Ewell constituency is also on behalf of the local IsItFair council tax protest campaign.
	My petitioners
	Declare that year-on-year, inflation-busting increases in Council Tax are causing hardship to many and take no account of ability to pay: further that the proposed property revaluation and re-banding exercise will make an already flawed system even worse.
	The Petitioners therefore request that the House of Commons votes to replace Council Tax with a fair and equitable tax that, without recourse to any supplementary benefit, takes into account ability to pay from disposable income, such tax to be based on a system that is free from any geographically or politically motivated discrimination, and that clearly identifies the fiscal and managerial responsibilities of all involved parties.
	And the Petitioners remain, etc.
	To lie upon the Table.

ORHAN PAMUK

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Heppell.]

Denis MacShane: Orhan Pamuk is one of the greatest novelists in Europe, if not the world. He is Turkish, a man of Istanbul, where he has lived since he was born 53 years ago. His novels, which many Members of this House will have read, include "Snow" and "My Name Is Red". We are of course delighted that this year's Nobel prize for literature was awarded to our own Harold Pinter, but it is an open secret that Mr. Pamuk might be on his way to Stockholm as a Nobel laureate, had Harold Pinter not won the votes.
	As you know, Mr. Deputy Speaker, I am a long-time supporter of Turkey's ambition to enter the European Union. I have debated on French television with the former French President, Valery Giscard D'Estaing, why he is wrong to oppose Turkey's ambition to join the EU. I have written and spoken here, in Germany and in other European countries to make the case for Turkey.
	A great writer such as Orhan Pamuk is the perfect ambassador for a Turkey that is looking west to Europe—to the culture of Voltaire, Dickens and the Enlightenment, and to the great tradition of writing and reading that separates so much of European history from other cultures and regions. Yet far from celebrating Orhan Pamuk as an ambassador for Turkey—he was awarded the peace prize at the Frankfurt book fair last month, and his books have sold hundreds of thousands of copies in Turkey and can be found in translation everywhere in the world—we have the tragic spectacle of his going on trial and facing a terrible jail sentence. The trial is scheduled to begin on 16 December—in one month's time. If it begins, it will set back considerably Turkey's ambition to join the EU. It will become a show trial such as we have not seen since the darkest days of the Soviet Union. Mr. Pamuk's trial has caused outrage all over Europe. My right hon. Friend the Foreign Secretary and the Minister for Europe have protested against it, and I know that my hon. Friend the Minister responding to this debate will make the Government's position clear tonight.
	So why is this great novelist facing trial and a prison sentence next month? The answer is that he gave an interview to a Swiss newspaper earlier this year, in which he said that a
	"million Armenians and 30,000 Kurds were killed"
	in Turkey in the last century.
	That is an historical fact. He did not use the word "genocide" or seek to attribute blame. The Turkish Government have opened their archives on this sad period in Turkish history and have asked the Armenian Government to do the same—a suggestion that Armenia would be well advised to take up, as this matter must be settled by academic, historical and forensic investigation, rather than ideological name-calling in the Parliaments of Europe and the world.
	Alas, however, there is a section of fundamentalist nationalist jihadis in Turkish politics, the Turkish media and Turkish state administration who reject any notion of discussing the history of Turkish massacres as history, rather than as contemporary politics. They called for Orhan Pamuk to be silenced, and he received so many death threats—a Turkish nationalist version of the fatwa pronounced against Salman Rushdie—that he left Turkey earlier this year. I met him then as a Minister, and invited him to the Foreign Office in April. We had lunch that day with the Turkish ambassador here in London, and we had a conversation as between civilised people about the Armenian deaths of 90 years ago. I urged the Turkish Government to do all that they could to protect Mr. Pamuk. But instead of the Turkish judiciary protecting this man against the death threats that he received, and the vituperative abuse that he received from the Turkish tabloid press, we have the sad sight of an Istanbul public prosecutor launching a prosecution against him, charging him with public denigration of Turkish identity.
	The prosecutor cited—in effect, hid behind—article 301 of the Turkish penal code. This code is supposed to be reformed to bring it into line with Council of Europe and EU norms, as part of Turkey's preparation for negotiations on future EU membership. Alas, we see that a malign fundamentalist state functionary can take words from the code and use them to launch an attack on free speech and freedom of expression that one might expect in a repressive Ba'athist, Islamicist or other dictatorship, but not in a nation whose culture is long and glorious, whose writers and intellectuals have much to bring to Europe, and whose self-confidence as a Turkish nation secure in its identity is in no way under threat from one of its great novelists.
	Let me make it clear that the issue of the Armenian massacres of 90 years ago is not a taboo subject. I was a British delegate at the NATO Parliamentary Assembly in Copenhagen. This very morning, I heard the Turkish Prime Minister, Mr. Erdogan, discuss the problem in a calm, sensible and matter-of-fact way.
	Last month, a group of scholars in Istanbul held a conference to discuss the Armenian issue. They, too, had to run the gauntlet of court orders trying to ban the event, and were accused in the Turkish equivalent of our tabloid press of being traitors to Turkey. However, the conference had the support of Turkey's Foreign Minister, Abdullah Gul.
	This morning, when he took questions after his excellent speech, I asked Mr. Erdogan about the Orhan Pamuk case. I asked him to make it clear that the Government of Turkey did not support the prosecution against Orhan Pamuk. Mr. Erdogan talked about the separation of powers between the judiciary and the Executive but, much as I am an admirer of Montesquieu, I know of no Government in the world who cannot find a way of not shooting themselves in the foot. The very great damage that the Orhan Pamuk trial would do to Turkey, if it is allowed to go ahead, should give even the most nationalist Turkish MP, prosecutor or judge pause for thought.

Frank Cook: I heard the Turkish Prime Minister in Copenhagen this morning, and he responded to the points made to him with great candour. Does my right hon. Friend agree that seeing how Turkey's judiciary handle the charges—misplaced though they may be—might give us an opportunity to measure that country's progress towards a mature, western-style democracy? The charges might be dispelled, so does not the case provide an opportunity for the country to prove that it has come of age?

Denis MacShane: For Mr. Pamuk, the notion that he should go on trial and then see what the judge decides is rather a miserable option. Although the separation of powers between Executive and judiciary is well known, prosecutions are partly a matter for the state as well as for the prosecuting authorities. The penal code is wholly a matter for the legislature. As I develop my speech, I shall argue that we should not wait to see whether Mr.   Pamuk is acquitted or given only a light or suspended sentence. I shall argue that Turkey should seize the opportunity to send a signal to the world that it is firmly on the democratic path, much as my hon. Friend has suggested.
	Let me report to the House what Mr. Erdogan said in response to my intervention this morning. As a former journalist, I noted down his interpreted words carefully. He said:
	"Our hope and desire is that the judicial decision will be in line with the freedom of expression and freedom of thought."
	I welcome that statement from the Prime Minister of Turkey but I would urge him now as a matter of urgency to find ways of suspending or amending article 301 of the penal code before the trial even starts. I plan to attend the trial, and I appeal to all Members of this House, and to fellow parliamentarians in Europe and the other democracies of the world, to show their support for a free Turkey by coming to the trial or otherwise manifesting support for Orhan Pamuk.
	However, friends of Turkey do not want to see a drawn-out trial which, even if it ends with Orhan Pamuk not going to prison, will none the less only damage the good name of Turkey around the world. This is not simply a question of one writer: the editor of the weekly paper Agos, Mr. Hrant Dink, was found guilty by the Istanbul Sisli court and given a suspended six-month sentence for writing an article in which he was said to insult "Turkish identity." However, no one involved in the trial could point to a single sentence that justified this charge. Does Turkey really want to become the new land of Kafka, a latter-day home of Orwell's thought crimes, the kind of country where the Islamicist censorship machine would welcome article 301 of the penal code?
	Even today, the Sabah daily newspaper reported that a prosecutor in Ankara had said that former head of Turkey's respected human rights advisory board, Professor Ibrahim Kaboglu, and his colleague, Professor Baskin Oran, were to charged with "insulting the judiciary" because they published a report saying that Turkey discriminated against people with separate sub-identities.
	I am sorry, but in today's Europe many groups in our different nations feel that they are discriminated against. I do not know whether the human rights professors are correct, but in Europe we defend to the death their right to make their point. Alas, that is not the case in Turkey, where the state prosecutor in Ankara is invoking article 301 to prosecute those two academics, who can face prison sentences if convicted.
	Frankly, I find it hard to believe that I am standing in the House of Commons making a speech about a writer and about journalists and intellectuals in a country that is seeking to become a member state of the EU.
	After my exchange with Prime Minister Erdogan in Copenhagen, I was buttonholed by a Turkish MP. I did not catch his name, but he told me that he thought that his Prime Minister had gone too far in supporting freedom of expression and that Pamuk was guilty of insulting the Turkish nation. I was pretty rough with him. I said that he would not last long in European politics. If every time that someone wanted to discuss a murky episode involving the deaths of many thousands, even hundreds of thousands of people in British or French or German history because of the cruelty or racism of the state, they were accused of insulting the British or French or German nation, all debate would dry up.
	Listening to that Turkish MP, I thought that I was listening to an Islamic fundamentalist from Iran, or a Ba'athist supporter of Saddam Hussein in Iraq, but he was a fellow MP from a country in NATO that hopes to join the European Union. Instead of modernising Turkey, there appear to be many in Turkish politics and the judicial system who want to bring back ultra-nationalism in order to stop Turkey joining the European Union.
	Orhan Pamuk, sitting and writing in that great cradle city of European civilisation, Istanbul, wants tomorrow's Turkey to look west. The men prosecuting him want to revert to pre-Atatürk days and turn Turkey's face to the dark nationalisms and censorship fundamentalisms of Turkey's eastern neighbours. When General de Gaulle, the French President, was suffering intolerable insults and abuse and calls to insurrection and the overthrow of state authority from the writer Jean-Paul Sartre, in the first period of de Gaulle's presidency after 1958, some smart French official found a law that would justify locking up Sartre and stop his inflammatory utterances. De Gaulle said only:
	"France does not arrest Voltaire."
	The idea that Orhan Pamuk will go on trial is an affront to every person in Turkey who wants that great country to modernise, reform, democratise and prepare for a 21st century future as a great Mediterranean civilisation and European nation. The decision of the prosecutor comforts all those anti-Turkish politicians in Europe who want to slam the door shut in Turkey's face almost as soon as the negotiations on EU membership have begun.
	I am grateful to my right hon. Friends the Foreign Secretary and the Minister for Europe and to our excellent ambassador in Ankara, Sir Peter Westmacott, for the clear position that they have taken on this case. I ask my hon. Friend the Minister replying tonight to make progress on the following points. He need not reply directly tonight—I would be happy if he would put a letter in the Library. First, I ask him to write to OlliRehn, the EU Commissioner responsible for enlargement negotiations, to ask him to consider making a condition of Turkey joining the EU either the removal of article 301 or the introduction of some clear freedom of expression clause that would override the abusive way that that clause has been used.
	Secondly, I ask my hon. Friend to continue—in bilateral governmental meetings with the Turks—to underline the importance that Britain, as expressed by the Commons and the Government, attaches to the charges being dropped. Thirdly, if the trial does go ahead, I ask my hon. Friend to help MPs and others from PEN or British writers' bodies, in conjunction with the excellent human rights department of the FCO, with travel and other costs necessary to attend the trial. Fourthly, I would like the Government, as the current holder of the presidency of the EU, to issue a formal statement expressing concern about the trial and to publish it in leading Turkish newspapers. I hope that my hon. Friend the Minister will also consider placing a statement reflecting his reply to this debate on the FCO website.
	Fifthly, I ask the Government to welcome the concern expressed by Prime Minister Erdogan and Foreign Minister Gul about the decision by state prosecutors to use the article 301 of the penal code for clear censorship purposes, in breach of European values of freedom of expression. Finally, I ask our embassy in Ankara to translate and make available the full Hansard report of tonight's debate to MPs and opinion-formers in Turkey.
	I deeply regret having been obliged to debate this issue on the Floor of the House. I am and will remain a supporter of Turkey's bid for full European status, but that can happen only on the basis of freedom of thought, freedom of expression and freedom of publication. Orhan Pamuk is one of the greatest ornaments to the new Turkey that is taking shape. I hope that as he reads this debate and my hon. Friend's reply he will understand that he has friends in the mother of Parliaments. We will stand by him until he and his fellow Turks enjoy the same rights and freedoms that belong to every citizen of the European Union.

Ian Pearson: I congratulate my right hon. Friend the Member for Rotherham (Mr. MacShane) on securing this debate. He is a long-time champion of intellectual freedom, as well as of Turkey's accession to the European Union, and he made a passionate speech.
	I begin by officially placing on record the Government's serious concern about the charges brought against the renowned author, Orhan Pamuk. Our hope, which has also been expressed by the Turkish Foreign Minister, is that Mr. Pamuk will be acquitted at the next hearing on 16 December. I also want to register concern about the recent charges, mentioned by my right hon. Friend, brought against the authors of a report reviewing Turkey's approach towards its minority constituencies. That is a most unwelcome development.
	I was delighted that we were able to open accession negotiations with Turkey on 3 October. That has long been an objective of the Government. We feel strongly that Turkey's prospective accession will be good for the UK, good for the EU and good for Turkey. One of the primary motivations for our policy remains our firm belief that the prospect of EU membership is providing a major impetus for a fundamental transformation of Turkey and, most important, encouraging greater respect for human rights.
	With the prospect of EU membership maintained through the launch of negotiations, I am confident that Turkey's leaders will be able to continue on the path of reform that has brought them so far. I thank my right hon. Friend for this opportunity to focus minds on the task that lies ahead and, by citing the specific example of the charges brought against Orhan Pamuk, for highlighting the fact that we might not expect the transition in Turkey to European standards to proceed entirely smoothly.
	Last year, the December European Council was able to conclude that Turkey
	"sufficiently fulfilled the Copenhagen political criteria"
	due to the remarkable progress that the Turkish Government had made in their decisive and far-reaching reform process. Although it was widely acknowledged that the legislative framework in Turkey was much improved, it was also clear that full and consistent implementation of the reforms introduced would require concerted effort over a number of years.
	The Government are convinced of the Turkish Government's commitment to reform. In response to the publication, on 9 November, of the European Commission's 2005 regular report on Turkey's progress towards accession, the Turkish Foreign Minister said:
	"Our government is determined to implement the reforms, to deepen and strengthen democracy. We know our own deficiencies and we are determined to overcome them in the coming process."
	The Commission report noted that
	"political transition is ongoing in Turkey",
	but that
	"the pace of change has slowed in 2005 and implementation of the reforms remains uneven".
	The report is clear about the significance of the new Turkish penal code and related pieces of legislation that recently came into force. It says that those
	"should lead to structural changes in the legal system, particularly in the judiciary".
	Of the penal code, it notes that
	"in general, the Code adopts modern European standards in line with criminal law in many European countries",
	but that
	"concerns remain regarding articles which may be used to restrict freedom of expression".
	The UK, like the European Commission, has been concerned that a number of decisions in Turkey, in relation to the expression of non-violent opinion, have led to both prosecutions and convictions. Notable among them were the charges brought against Orhan   Pamuk, but also the prosecution on 7 October, mentioned by my right hon. Friend, of the Turkish writer, Hrant Dink, for insulting the Turkish identity, and the recent charges brought against the authors of a report on Turkish policy on minorities.
	I assure my right hon. Friend that, in our presidency, we have raised our concern about the case of Orhan Pamuk with the Turkish Justice Minister, in early September in the margins of the justice and home affairs informal ministerial, and again when Baroness Scotland visited Ankara on 11 November. Our ambassador in Ankara raised the case with the Turkish Foreign Minister last week, and drew his attention to the exchange in the House on 1 November that concluded that further reform would be necessary. Senior Turkish politicians believe that it is inappropriate for them to intervene, given the independence of the judiciary, but they expect the case to be dismissed when it goes to trial. I can confirm that European diplomats will attend the trial scheduled for 16 December.
	Several recent judgments suggest that the judiciary is increasingly acting in accordance with the case law of the European Court of Human Rights. For example, on 24 October, a journalist, Rahmi Yildirim, who was facing trial for insulting the army, was acquitted after the prosecutor said that his article was not designed toinsult anyone. International non-governmental organisations have suggested that broad and poor interpretation of the new penal code by the judiciary is, in part, the result of the vague wording of some of its articles.
	The European Commission agrees with that view and has said that it is most concerned about the articles that refer to offences against symbols of the state and its institutions, including article 301, under which Mr. Pamuk has been charged. Although equivalent articles exist in some parts of the EU, it is crucial that the judiciary enacts the legislation as the political Administration intend. The Commission's regular report states:
	"If the code continues to be interpreted in a restrictive manner, then it may need to be amended in order to safeguard freedom of expression in Turkey."
	The Turkish Prime Minister has himself acknowledged that further amendments to the code may be required and that the process of revision may continue for some years.
	The European Commission has also stressed that, in tandem, efforts to train judges, prosecutors and lawyers must be sustained. My right hon. Friend will know that, last year, the UK co-sponsored a project with the Turkish Ministry of Justice to train more than 8,000 judges and prosecutors in European law and human rights. It is encouraging therefore that, perhaps as a direct result of that and similar training programmes, the courts are reported to have referred to the European convention on human rights in 224 judgments since 2004. Clearly, it is of paramount importance that the judiciary fully understands the provisions of the convention. An amendment to the Turkish constitution in May 2004 recognises the supremacy of international instruments over domestic legislation, in effect, binding Turkey to the provisions of the convention, including article 10 on freedom of expression, and providing a means of recourse when poor decisions are made.
	Turkey's human rights record and the functioning of its judiciary will be subject to intense scrutiny during accession negotiations, and advancement in negotiations will be guided by Turkey's progress. The UK and EU will continue to stress to Turkey the need to safeguard freedom of expression and will raise cases, like that of Orhan Pamuk, where strong disparities with EU practice are clearly evident. However, notwithstanding the fact that Turkey must address such shortfalls, we should set them in the wider context of a country where a fundamental transformation is taking place rapidly to embrace enhanced democratisation—a transformation that we might not realistically expect to be achieved overnight or straightforwardly, but a transformation none the less and one of which my right hon. Friend is extremely supportive.
	The reforms of recent years in Turkey have been hugely impressive. They have required great courage on the part of Turkey's political leaders, and the challenge of overseeing their implementation could be tougher still. The Turkish Government will have to work hard to bring about the culture shift required, and they might expect to encounter points of resistance. Again, my right hon. Friend mentioned them in his contribution.
	The Government, however, are of the firm conviction that Turkey's leaders possess the will to see the process of reform through to its successful conclusion. The Turkish Prime Minister has always said that the reforms are first and foremost for the Turkish people themselves. The EU process has always underpinned the process of reform and acted as a spur to it. With the launch of negotiations, Turkey has set a course to follow for the future. I hope that we will all soon look back on events such as the charges facing Mr. Pamuk as the growing pains of a country maturing into a developing democracy.
	Having said that, it is important to recognise the here and now, and the situation that Mr. Pamuk faces. I stress the importance that the Government attach to the points made by my right hon. Friend. Clearly, the UK cannot interfere in the Turkish judicial system, but we do not believe that Mr. Pamuk should be brought before the courts. We will continue to make representations to the Turkish authorities about his case.
	I will gladly write to my right hon. Friend about the specific points that he made in his speech. The Government want to continue to raise our serious concerns about the fact that Mr. Pamuk is being brought before the courts.
	Question put and agreed to.
	Adjourned accordingly at fourteen minutes to Eleven o'clock.